Anunaya R. Jain

Latha Stead

MB Heller

Wyatt Decker

International Journal of Emergency Medicine

English

PubMed

Springer - Publisher Connector

EDITORIAL
Ultrasound in emergency medicine: a colorful future in black
and white
Anunaya R. Jain & Latha Stead & Wyatt Decker
Received: 20 October 2008 /Accepted: 21 October 2008 / Published online: 21 November 2008
# Springer-Verlag London Ltd 2008
From the experiment using an underwater bell to determine
the speed of sound by J. D. Colladon in 1826, the
generation of ultrasound waves by Francis Galton in
1876, the discovery of the piezoelectric effect by Pierre
Curie in 1880, the development of sonar systems within a
month of the sinking of the Titanic in 1912, to its early
conception as the “hydrophone” by Paul Langevin and
Constantin Chilowsky in 1915 and the development of
medical ultrasonic systems since 1940, ultrasound is a
technology that has now reached the “tipping point” and is
being rapidly assimilated into multiple medical specialties
beyond radiology.
Emergency medicine (EM) has witnessed the addition of
ultrasonography to the arsenal of emergency care. The history
of ultrasound in EM, spanning 15 years, can be traced back to
the publication of the first emergency ultrasound curriculum
by Mateer et al. in 1994. Increasing portability and the ease of
training has fueled its rapid ascent to the front lines of EM
practice to improve patient care.
Since the publication of the first formal policy statement
for the use of ultrasound in EM by the American College of
Emergency Physicians in 2001 [1], the concept of emer-
gency screening ultrasound has gained favor with most of
the residency training programs in the USA and is now an
element of the core curriculum required by the Residency
Review Committee for Emergency Medicine [2]. It was
also recently incorporated in the guidelines of the College
of Emergency Medicine, UK in 2006 [3]. A large body of
research studies has provided strong evidence that with
appropriate training emergency ultrasound done by emer-
gency physicians can safely aid time-critical decisions and
procedures in the emergency department (ED).
The gamut of emergency ultrasound has gone from
FAST (focused sonography for trauma) to comprehensive
advanced scans and procedural guidance such as scans for
shortness of breath, increased intracranial pressure (ICP),
and central line placement. The ability of ultrasound to be
incorporated in emergency medical services (EMS), tele-
medicine, and medical student education has mushroomed
interest in the field. We are pleased to feature ultrasound in
this issue of the International Journal of Emergency
Medicine. The first of the ultrasound articles in this issue
is a review on its use in EMS [4]. Not only does it highlight
the current status of its use in Europe and the USA, but it
also provides insight into the training programs, point of
care use in resuscitation and trauma by EMS, and the
potential application in mass casualty incident triage. There
is still a long way to go as far as credentialing EMS
personnel is concerned, because of the known learning
curve in ultrasound applications.
The growth of ultrasound in EM is twofold—first is the
development and validation of new point of care applica-
tions aptly demonstrated in the brief research report on
“Ultrasound as an aid to reduction of pediatric forearm
fractures” [5]. This application of ultrasound helps visually
demonstrate successful reductions. Although the study did
not demonstrate a decrease in the treatment time or
Int J Emerg Med (2008) 1:251–252
DOI 10.1007/s12245-008-0078-3
A. R. Jain
Department of Emergency Medicine, Mayo Clinic,
Rochester, MN, USA
e-mail: jain.anunaya@mayo.edu
L. Stead :W. Decker (*)
Emergency Medicine, College of Medicine, Mayo Clinic,
Rochester, MN, USA
e-mail: decker.wyatt@mayo.edu
L. Stead
e-mail: stead.latha@mayo.edu
radiological exposure, further validation will likely do so.
The novelty of ultrasound applications has only multiplied
with time, but the result remains the same: success.
The second prong of growth is the promulgation of basic
training in developing systems of care as is exemplified in
the study on “Introduction of a portable ultrasound unit into
the health services of the Lugufu refugee camp, Kigoma
District, Tanzania” [6]. The study demonstrates the feasi-
bility and the ease with which ultrasound can be adapted to
use in complex, underdeveloped care systems to enhance
patient care and satisfaction. This article goes a step further
to demonstrate that the initial expenditure for procuring the
equipment is greatly offset by the time gain and the
decreased stress on ancillary medical departments in
developing systems.
The socioeconomic pressures of health care in all
economies ranging from developed, developing and the
underdeveloped will benefit from this boom of ultrasound
in EM. But at the same time we must be wary that
ultrasound in EM does not become a victim of its own
success. Appropriate training and credentialing is the need
of the hour.
The spiraling growth of ultrasound in EM has only one
foreseen outcome, a future made colorful by black and
white.
References
1. ACEP Policy Statement (2001) Emergency Ultrasound Guidelines.
Approved ACEP Board of Directors
2. Heller MB, Mandavia D, Tayal VS et al (2002) Residency training
in emergency ultrasound: fulfilling the mandate. Acad Emerg Med
9(8):835–839
3. Emergency medicine ultrasound—level 1 training document (2006)
College of Emergency Medicine, Ultrasound Subcommittee. March
4. Nelson BP, Chason K (2008) Use of ultrasound by emergency
medical services: a review. Int J Emerg Med doi:10.1007/s12245-
008-0075-6
5. Wong CE, Kee-Chong Ng, Angeline A (2008) Ultrasound as an aid
to reduction of pediatric forearm fractures. Int J Emerg Med
doi:10.1007/s12245-008-0072-9
6. Adler DH, Mgalula K, Price D, Taylor O (2008) Introduction of a
portable ultrasound unit into the health services of the Lugufu
refugee camp, Kigoma District, Tanzania. Int J Emerg Med
doi:10.1007/s12245-008-0074-7
252 Int J Emerg Med (2008) 1:251–252


Ultrasound in emergency medicine: a colorful future in black and white

Crossref

Angeline A

Emergency medicine ultrasound—level 1 training document (2006) College of Emergency Medicine, Ultrasound Subcommittee.

Emergency Ultrasound Guidelines.

Introduction of a portable ultrasound unit into the health services of the Lugufu refugee camp,

Tayal VS et al (2002) Residency training in emergency ultrasound: fulfilling the mandate.

Use of ultrasound by emergency medical services: a review.

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Ultrasound in emergency medicine: a colorful future in black and white

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