German emergency department finds POCUS indispensable

Evangelisches Krankenhaus Unna, a district hospital in Germany, has a certified stroke unit and a trauma centre. It sees more than 20,000 patients a year in its emergency department where point-of-care ultrasound (POCUS) has become an indispensable tool, particularly for the acute care of severely injured patients admitted to the resuscitation room.

Lead consultant Dr Martin Langer has a background in emergency medicine, intensive care and palliative care, as well as expertise in using ultrasound in these settings. He said: “We’ve been using POCUS in the department for 15 years now, and could not do without it. We routinely perform eFAST (extended focused assessment with sonography for trauma) examinations on severely injured patients within the first minutes after their admission. This allows us to quickly check the condition of the heart and the integrity of the lungs, and see if there is any free-flowing fluid in the chest or the abdomen.

“We can determine instantly whether the patient has a potentially life-threatening condition, such as a collapsed lung or heavy bleeding in the abdomen, that requires immediate action before any further diagnostic tests may be carried out.”

The availability of POCUS in the department means fewer x-rays and a reduction in invasive procedures for patients. Previously x-rays were taken to look at the lungs or insert a cannula to flush fluid through a patient’s abdominal cavity to check for blood. “Now, we nearly always perform a non- invasive ultrasound examination instead, which gives us the same information but is much better for the patient. If emergency surgery is required, ultrasound imaging can be complemented by a CT scan.”

The hospital has had a long association with Fujifilm SonoSite and the SonoSite X-Porte system is its latest addition. Dr Langer said: “It is such a comprehensive device, with excellent image quality and a large display screen. It is mobile and robust, and it is essential that the instrument is sturdy, vibration free and not easily damaged, because we are constantly moving the system between patients. When the instrument is not in use, we place it on the PowerPark docking station to recharge.”

Picture: Lead consultant Dr Martin Langer with the SonoSite X-Porte.

Published on page 18 of the July 2019 issue of RAD Magazine.