Most emergency physicians are familiar with bedside ultrasound and the focused assessment with sonography for trauma (FAST). Although FAST can be helpful, “some of us have moved beyond the protocolized approach to trauma ultrasound,” said Matt Dawson, MD, RDMS, RDCD, director of point-of-care ultrasound and associate professor at the University of Kentucky in Lexington.
Dr. Dawson said that he uses FAST, but that there are other ultrasound tools emergency physicians can try. He’ll discuss those tools at his talk, “Rapid Fire: Beyond FAST: Trauma Ultrasound Today.”
Those interested in discovering new uses for ultrasound will want to attend this interactive presentation, Dr. Dawson said.
“Ultrasound can be used for so many things other than the eFAST [extended FAST] in the trauma patient,” he said. “If the patient is crashing and the eFAST is negative, you could recognize pubic symphyseal widening with ultrasound to help confirm that the bleeding is in the pelvis. You can also diagnose musculoskeletal injuries. Possibly an even more beneficial use of ultrasound in the multitrauma patient is treatment of those painful injuries with ultrasound-guided nerve blocks.”
The latter can be a quick and efficient method to help control pain in certain patients, Dr. Dawson said.
In his session, Dr. Dawson will address cases where emergency physicians can use skills such as confirming intubation in the crashing patient, marking the cricothyroid membrane to speed up to cricothyrotomy, diagnosing musculoskeletal injuries at the bedside, and making critical decisions in more complex hypotensive crashing patients.
“For example, if a hypotensive patient has both a pericardial tamponade and free fluid in the abdomen, the audience will be taught how to differentiate the cause of hypotension and decide on immediate treatment with inferior vena cava ultrasound,” he said.
Attendees will also discuss how to recognize crashing trauma patients who may not actually be trauma patients—and how to treat them appropriately.
Dr. Dawson said that his talk will be of interest both to physicians who see frequent trauma cases, as well as those who see them less often. “This talk will discuss some cutting-edge uses of ultrasound to take better care of those patients. If you don’t see trauma very often, most of the skills are useful for other patients as well,” he said.
For more information about the uses of ultrasound in the ED, check out Dr. Dawson’s www.ultrasoundpodcast.com or follow him on Twitter at @ultrasoundpod.
Vanessa Caceres is a freelance medical writer based in Florida.