The course on EM ultrasound was very good, and filled in a few gaps for me. The instructors were incredibly knowledgable and patient, and skills of this sort aren’t taught by lecturing alone, there has to be some practical, hands on demonstration and training.
We had several ‘donated’ very nice ultrasound machines with their sono technician corporate educators (people who sell that brand of ultrasound machine) to answer all of our questions about which buttons do what and ‘how do you make it quit that’ sort of questions. Ultrasound machines now are incredibly capable, even in the more base models that are marketed to Emergency Departments. The sales force wasn’t teaching, by the way, the course instructors were, but as most were using machines thay weren’t personally familiar with, we needed a little orientation, at least at first.
What are ultrasounds used for? To examine specific parts of the body, and in Emergency Medicine, to answer specific questions (“It’s not a tricorder to help find disease” was one memorable quote). How do you practice ultrasound? On human models, which finally gets me to the point. Yes, they were all monetarily compensated for being there, and they were all very good at being still and letting us all slather them with ultrasound gel while the 60th person examined their liver/kidney/diaphragm/spleen/anotherkidney/heart/bladder, and later, their gallbladders and aortas. The ones who were most useful were the ones who consented to being models for endovaginal ultrasound (EVUS).
EVUS is very very useful in EM, and is an important diagnostic tool/question answerer. It consists of a high frequency probe (with appropriate protection and gel) being inserted into the EV region for a very detailed look at the uterus to answer specific questions (Pregnancy in the uterus or not? It’s important to know in many instances). The models were all yound and healthy, and it amazes me people will model as such to help their fellow humans. Or, it could just be mercenary desire for cash, but there’s got to be a better way to make money than that. The docs were all very correct and all I worked with were very polite and courteous toward our US models.
And thanks, models, for helping us help others.
Good stuff, Doc…keep ’em coming. Nice to hear what “my” docs are doing when they trundle off to CE conferences.
Since I left the academic world two years ago I have not performed a single ultrasound. Several reasons. First all it takes is a phone call and I get an ultrasound within twenty minutes, 24/7. Our group won’t buy one. “Why start now?” they say. I am not sure it is cost effective. I can see one or two other patient in the time it would take to perform an ultrasound. I think it would lead to longer patient waits, for things as important as pimples, hangnails and chronic conditions that the Mayo Clinic can’t diagnose.
Do you use US in your practice now? How many private EM practitioners us it?