Emergency ultrasound

In the emergency setting, it is used to guide resuscitation and monitor critically ill persons, provide procedural guidance for improved safety and confirm clinical diagnosis.

Traditionally used by emergency physicians and surgeons treating trauma persons, it has also been used by paramedics[9] in combat zones,[2] and for non-traumatic problems such as ruptured ectopic pregnancy.

[10][11] Evaluation of the heart and inferior vena cava (IVC) can help the clinician at the bedside choose important treatments and monitor the response to the interventions.

[12][13] A person who has hypotension and a bedside ultrasound showing hyperdynamic left heart with a flat, collapsible IVC indicates low blood volume.

Conversely, weak heart activity and a very full, non-collapsible IVC would indicate a cardiac cause for low blood pressure.

[17] More recent evidence suggests that ultrasound assessment of more "peripheral" veins (e.g., subclavian, femoral, internal jugular) may also be helpful in estimating intravascular volume status in the absence of IVC visualization.

Those presenting with chest pain, focused cardiac ultrasound can be helpful in the evaluation of persons with potentially life-threatening disease such as a pericardial effusion, a severe pulmonary embolus (or blood clot in the lungs), or in screening those with suspected aortic dissection.

[12] The use of ultrasound is also helpful in persons with chest pain due to suspected heart ischemia, especially when the baseline electrocardiogram or EKG, is non-diagnostic.

[37] Ultrasound has been described to detect retinal detachments, vitreous hemorrhage, dislocation of the lens, as well as evaluating optic nerve sheath diameters as a potential indicator of other diseases in the central nervous system.

Many physicians are currently taught bedside ultrasound during the emergency medicine residency or critical care fellowship training programs in the United States.

There are specialized fellowship training programs for bedside ultrasound in emergency medicine, but these are not required nor expected for the use of this tool in practice.