POC ultrasound an integral part of emergency care at St Mary’s

St Mary’s Hospital is one of London’s four major trauma centres and uses point-of-care ultrasound extensively in the assessment of patients visiting its extremely busy A&E department. Dr Ehsan Hassan, a consultant in emergency medicine with a special interest in ultrasound, explained: “Our normal practice with trauma patients is to perform a FAST scan during the primary survey. This can make a significant difference to the care of unstable patients – for example, stab wounds to the heart – giving you a diagnosis straight away. This approach has enabled some patients to be fast-tracked into theatre.” The department’s SonoSite X-Porte ultrasound system is based in resuscitation, although its portability means it can be easily moved to other areas of A&E as required. Dr Hassan continued: “The Royal College of Emergency Medicine requires that all A&E consultants are trained to perform FAST (Focused Assessment with Sonography in Trauma), aortic scans, IV access and basic echo. However, once you are familiar with the techniques, it has a role in assessing so many different conditions – shock patients, abdominal pain, query ectopic pregnancies, pneumothoraces or hemothoraces, and numerous musculoskeletal complaints – as well as for draining pleural effusions and placing central or difficult-to-access IV lines. It is a very versatile technique.”

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