By Dr Owen Doran, ED Specialist, Auckland AED Ultrasound Lead
We currently have two ultrasound machines in our department- an older Envisor (Philips) and our new machine, the Sparq (also a Philips machine). We were the first emergency department in Australasia to own the Sparq, and it has been put to good use – its size, manoeuvrability and ease of use have made it popular. The image quality is also an improvement on our older machine.
Being a major trauma centre, the main use of ultrasound in the department is FAST and EFAST in the resuscitation room. This has allowed timely assessment for free intra peritoneal blood in our unstable trauma patients, supporting decisions regarding further management.
We also perform a number of screening scans for AAAs- particularly in older (>50yo) patients with undifferentiated abdominal pain. This has in the past, and will likely in the future been lifesaving.
The third biggest area of use has been procedural ultrasound- particularly for vascular access. As well as using ultrasound for safe central venous access, we are increasing using ultrasound for difficult peripheral access. This certainly saves time and patient discomfort. With the recent purchase of a peripheral and internal jugular phantom, we will be able to improve our teaching of these vital skills.
The next application where I think ultrasound will benefit our patients will be in patients with shock. There are a number of protocols (e.g. RUSH) that have been shown to be beneficial to patients whose shock is poorly differentiated- aiding diagnosis and guiding management. This is an area that I hope we will develop our skills as a group.
Our challenges in the near future include improving our accreditation for our senior doctors, and also developing ultrasound skills amongst our trainees.
Click here for information and documentation regarding accreditation
Click here for a list of web-based ultrasound resources