The Purpose of Ultrasound

Emergency physician performed ultrasound is a focused, limited technique to answer a single question.

The purpose of ultrasound in the initial assessment of abdominal trauma, is solely to document the presence of free intra-peritoneal fluid.

In the context of trauma this fluid is assumed to be blood but this may not actually be the case. There is no attempt to visualise specific organ injuries, as ultrasound is not accurate in the early assessment of solid organ or hollow viscus injury [9].

The absence of free fluid does not exclude serious intra-abdominal injury.

Ultrasound has the advantage of being non-invasive, rapidly performed and readily repeatable.

Further management is dictated by the clinical condition of the patient. Ultrasound is designed to complement other investigations such as Diagnostic Peritoneal Lavage (DPL), which is very sensitive but not without disadvantages. However, Computed Tomography (CT) will remain the gold standard.

The fact that there is usually some delay in obtaining a CT scan, and transfer out of the department necessitates a haemodynamically normal patient, means that ultrasound in the resuscitation room becomes very useful in rapid diagnosis.

Learning bite

Ultrasound complements other investigations, and CT remains the gold standard to detect intra-abdominal injury.

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