Clinical note
Emergency department sonography by emergency physicians

https://doi.org/10.1016/0735-6757(89)90283-0Get rights and content

Abstract

A retrospective study was conducted to examine whether emergency physicians can perform accurate ultrasonography that influences the diagnosis and treatment of selected disorders in the emergency department (ED). The physicians acquired a moderate level of expertise in sonography using a series of practical demonstrations and lectures. Patients with symptoms suggestive of cardiac, gynecologic, biliary tract, and abdominal vascular disease periodically underwent ED sonography. The initial interpretation was used as a diagnostic adjunct to subsequent therapy. The accuracy of positive sonographic findings was assessed by confirmatory testing, formal review, or confirmatory clinical course. Emergency physicians were able to diagnose correctly (1) the presence and approximate size of pericardial effusions, (2) the presence or absence of organized cardiac activity in patient with clinical electrical mechanical dissociation, (3) the presence or absence of intrauterine pregnancy in pregnant patients with lower abdominal/pelvic complaints, (4) the position of intrauterine devices in patients with suspected uterine perforation, (5) the presence of gallstones in patients with suspected biliary tract disease, and (6) the presence and size of abdominal aortic aneurysms in patients with pulsatile masses or unexplained abdominal pain. It was concluded that reliable sonography which influences diagnosis and therapy can be performed by emergency physicians and that sonography should become a standard procedure in EDs.

References (50)

  • S Arvan
  • FP Hadlock

    The first trimester of pregnancy

  • TH Shawker et al.

    Early fetal movement: A real-time ultrasound study

    Obstet Gynecol

    (1980)
  • DA Sarti
  • RC Sanders
  • RA Filly et al.

    In vitro investigation of the origin of echoes with biliary sludge

    J Clin Ultrasound

    (1980)
  • National Institutes of Health
  • National Council of Radiation Protection and Measurements
  • American Institute of Ultrasound in Medicine
  • EL Cartensen et al.

    The effects of pulsed ultrasound on the fetus

    J Ultrasound Med

    (1984)
  • CR Stark et al.

    Short- and long-term risks after exposure to diagnostic ultrasound in utero

    Obstet Gynecol

    (1984)
  • SF Dorfman

    Deaths from ectopic pregnancy, United States, 1979 to 1980

    Obstet Gynecol

    (1983)
  • A Helvacioglu et al.

    Ectopic pregnancy: An eight year review

    J Reprod Med

    (1979)
  • AE James et al.

    Ectopic pregnancy: A malpractice paradigm

    Radiology

    (1986)
  • L Berlin

    Malpractice and radiologists

    AJR

    (1980)
  • Cited by (120)

    • GRACE-3: Be the baller

      2023, Academic Emergency Medicine
    View all citing articles on Scopus

    Presented in part at the American College of Emergency Physicians Annual Meeting, San Francisco, November 1987.

    View full text