International symposium on emergency medicine

Abstract
Ultrasound (US) has become an indispensible tool in emergency medicine. ACEP (
American College of
Emergency Physicians
) has published clinical statements and guidelines on use of emergency ultrasound
and US has thus gained official recognition in approach and treatment of trauma, intrauterine
pregnancy, AAA, cardiac, biliary and urinary tract US, diagnosis of DVT, musculo-skeletal conditions,
thoracic and ocular US and as aid with procedures. An emergency US is a complementary tool due to its
easy acces, lack of complicated preparations of either the machine, nor the patient, it is easily repeatable
and carries no risk of harmful irradiation and non-radiologists can learn specific, life-saving aspects of
particular exams. Conceptualy it differs from classic, comprehensive radiologic examination in its
focused search for life-threatening conditions (eg. cause of shock, dispnea) and diagnosis and decision-
making is dichotomous (is there specific pathology present?: Yes/No?). It is the threating physician that
is making direct clinical conclusions and pertinent decisions. Paralel to specific indications, there arose
systematic aproaches and algorhythms tailored to specific critical conditions, establishing US-enhanced
advanced life support. First of them was “FAST” that recently extended into E-FAST, there is “C.A.U.S.E.” as
cardiac arrest ultrasound exam
and “RUSH” as 
rapid ultrasound examination in shock
and uses widest array
of ultrasonographic signs to approach criticaly ill.
78
URGENTNA MEDICINA - IZBRANA POGLAVJA 2010

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tamponade in oceno CVP, okvirni pregled bulbusa in loka aorte (suprasternalno), iskanje prost tekočine
v trebuhu (kot FAST), oceno premera abdominalne aorte ter iskanje GVT.
Omenimo naj tudi protokol obravnave dispneje (“BLUE protocol”)(16), kot ga predlaga Lichtenstein in
ki nosi pribl. 85% uspešnost najdbe pravilnega vzroka dispneje.