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Emergency Ultrasound

Ask The Expert

Section Editor: Robert M. Bramante, MD, FACEP

Interview with Marek A. Radomski, DO, FACEP

Associate Chief of Emergency Services, UPMC-Presbyterian/Shadyside - Shadyside Campus
Director of Ultrasound Services, Department of Emergency Medicine - University of Pittsburgh Physicians
Assistant Professor of Emergency Medicine, University of Pittsburgh School of Medicine

Clinical Ultrasound: How do I work with other specialties?

Questions often arise among on how best to navigate the potential minefields that can exist between specialists and Emergency Physicians when performing clinical ultrasound studies in the point-of-care setting. The field of clinical ultrasound has expanded drastically over the course of the last several years with nearly all specialties using ultrasound in one capacity or another. The sentiment that only certain specialists should be performing ultrasound studies is obsolete and antiquated, but I find it especially important to have a good working relationship with as many other specialties as possible. Emergency Medicine as a discipline has outlined a specific fellowship in the field of clinical ultrasound, performs nearly every type of clinical ultrasound study, and has been performing these point-of-care studies as long as any other specialty -- positioning us to be leaders in the field.

When meeting with leaders from other specialties, I find it essential to discuss that while we are all using the same diagnostic tool, our end goals may be (and often times are) different. While clinical ultrasound exams are, by their very definition, limited studies and not meant to be comprehensive, these studies can be performed at any time of day, in nearly any location, and often drastically expedite and improve patient care. In addition, a significant number of clinical ultrasound exams are completed on hemodynamically unstable patients and simultaneously aid in diagnosis and treatment. Recognizing (and helping our non-EM colleagues recognize) the diagnostic advantage and improved patient care made possible by clinical ultrasound is paramount to not only a successful clinical ultrasound program at a particular institution, but also to expansion of the field.

Establishing clear guidelines and accepted practices when using clinical ultrasound helps keep all parties involved on the same page. In addition, the benefits of having many specialties involved are plentiful. Beyond the obvious benefit to the patient, collaboration between departments helps expand education and our overall knowledge base. Instead of each department having to “reinvent the wheel,” we can enhance the use of clinical ultrasound, develop better methods, and partner in research. The field of clinical ultrasound continues to expand out of Emergency Departments and into inpatient wards, ICUs, ORs, and outpatient clinics. Fostering collaboration and cross-functional understanding while leveraging our expertise as leaders in the field will undoubtedly contribute to improved patient care and expansion of the field.

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