Medical Minutes

When Seconds Count

Reaching diagnoses rapidly with emergency ultrasound.

A 60-year-old male suffering from acute abdominal pain is rushed to the emergency room with pain in his lower abdomen and in his back. His medical history is significant for hypertension and cardiovascular disease. After a clinical evaluation, the emergency physician immediately performs an ultrasound exam at the patient’s bedside to ascertain the cause of the patient’s pain.

When symptoms are acute, a rapid and accurate diagnosis is crucial. Abdominal pain is a common reason for patients to come to the emergency department, and their pain may be caused by any number of diseases, which may include the large vessels, gallbladder, kidneys, appendix, intestines, pancreas, liver, stomach or spleen.

Many of the disease processes associated with these organs can be readily detectable on emergent, bedside ultrasound. Following a medical history and clinical examination, ultrasound screenings have quickly become one of the first and most useful methods of investigation in the evaluation of a variety of emergent complaints. The use of bedside ultrasound to answer focused clinical questions offers many advantages to the patient over traditional modalities. It is safe, rapid, dynamic and non-invasive. Ultrasound is a powerful tool used as an extension of the clinical examination to diagnose or exclude urgent diagnoses.

“Emergency departments utilizing emergency screening ultrasounds report faster turn-around times and more expedient diagnosis of potential life-threatening emergencies such as internal hemorrhage following blunt trauma, abdominal emergencies, ectopic pregnancy, pericardial tamponade and aortic aneurysms,” states Dr. Steven A. Goodwin, M.D., Department of Emergency at the University of Florida Health Science Center.

A focused ultrasound, as the name implies, is intentionally a limited, goal directed exam with the expressed purpose of answering a select set of diagnostic questions. It is increasingly clear that focused ultrasound studies dramatically reduce patient length of stay in the emergency department, increase patient satisfaction and result in an even higher standard of care.

Patients in our emergency department require and deserve efficient, safe and accurate health care. Imaging at the patient’s bedside has had a major impact on patient care and is invaluable to emergency physicians and their patients providing immediate diagnosis, expedite treatment, increase safety and success of certain lifesaving procedures, while reducing radiation exposure. As an example, in a matter of seconds heart structures and function can be assessed enabling the emergency physician to move to therapeutic interventions more rapidly than ever before. When time is of the essence and a patient is experiencing acute pain, immediate diagnosis and treatment is invaluable.

In those unfortunate moments when you or a loved one is in need of emergency medicine, it’s comforting to know that PMC’s emergency physicians emphasize emergency ultrasound and have the only ultrasound fellowship-trained emergency physician in the state of Idaho. We are well qualified to deal with even the most complex medical concerns in a timely and specialized manner.

To find a physician, please call Portneuf Medical Center’s Physician Referral Line at 1-877-721-6673.

Dr. Dave Francis is a board eligible emergency medicine physician. He grew up in Salt Lake City, attended Penn State Medical School, completed Emergency Medicine residency training at NYU and subspecialized in Emergency Ultrasound through fellowship training at Stanford University. He joined PMC’s Emergency Department, in part, with the intent to be actively involved in training physicians and nurses in ultrasound procedures. As a father of four children, he anticipates many family memories will be made in the great Idaho outdoors.