Bedside cardiac ultrasound training should be mandated in the emergency department

Abstract

BACKGROUND Bedside cardiac ultrasound can be performed quickly and accurately in the emergency department to diagnose and treat cardiovascular causes of patient deterioration. In Australian emergency departments, it is an underutilised tool. This may be because becoming proficient at performing bedside cardiac ultrasound is not mandated by the Australasian College for Emergency Medicine. CASES Case 1: A 45-year-old male presented with hypoxia and shock and head injury. Findings consistent with pulmonary embolism on bedside cardiac ultrasound prompted rapid treatment with thrombolysis. The patient survived to hospital discharge.Case 2: A 54-year-old female presented with chest pain. Her bedside cardiac ultrasound revealed a dilated proximal aorta and a dissection flap in the abdominal aorta enabling investigations and operative management to be expedited.Case 3: A 21-year-old male presented with features of lower respiratory tract infection. Chest X-ray revealed a large heart and consolidation. Bedside cardiac ultrasound demonstrated severe dilated cardiomyopathy and prompted the patient's admission into the coronary care unit. CONCLUSION Evidence shows that emergency doctors can perform bedside cardiac ultrasound accurately after minimal training. It increases the accuracy of diagnosis. Training in this vital diagnostic tool should be mandated for emergency medicine trainees in Australia.