Many emergency physicians now view screening ultrasound as a tool, and not a proceedure or study. It is primarily used to quickly and correctly ascertain a limited set of internal injuries, specifically those injuries where conventional methods of determining them, such as trauma to the torso or heart, would either take too long, require too much time to prepare, or introduce greater risk to the patient.
While conventional ultrasound can be a lengthy process, and is usually conducted with non-mobile units and advanced image filtering and manipulation built into the unit, emergency ultrasound is as simple and quick to operate as possible, and narrowly focused on a small set of criteria.
The primary uses of emergency ultrasound are determining the severity of fluid or trauma to the midsection, determining immediate trauma or penetration of the heart, and to process sources and extent of internal bleeding. Specific implementations vary, some areas use the German originated FAST SCAN system which focuses on fluids in the paracolic gutter and the Douglas and Morrison pouch. Others focus more on cardiac ultrasounds.
In most cases, EMT's will deploy a portable unit. In every instance, an attempt is made to find the area best suited to an ultrasound and utilize bare skin if possible. Resolution is vastly decreased if soundings must be made through any form of clothing.
There are two main areas of emergency ultrasound. The FAST system focuses on trying to ascertain if there is internal bodily fluid in blunt abdominal trauma, in the areas between organs, which is a sign of severe internal injury. CARDIASOUND is used to attempt to find blockages, clots, or penetrations of the heart. Both systems are scanning methodologies, they use identical equipment.
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