Wave of the future: Portable ultrasound scanners in the ER can save lives by expediting diagnosis

Aug 18, 2009 by Kristina Lindgren
Dr. Chris Fox has trained UC Irvine Medical Center's emergency department clinicians to use ultrasound scanners to precisely diagnose in minutes life-threatening conditions. Image: Daniel A. Anderson / University Communications

All too often, a stethoscope and a doctor's touch are still the primary tools for diagnosing emergency-room patients. UC Irvine physician Chris Fox aims to change that.

Rather than feeling for a broken bone or swollen abdomen or merely listening to the heart, Fox has trained UC Irvine Medical Center's emergency department clinicians to use the latest in lightweight, high-resolution ultrasound scanners, allowing them to diagnose in minutes — and with striking precision — life-threatening conditions requiring immediate intervention.

The doctor became an evangelist for ultrasound when a young woman with breathing problems was rushed to the Chicago hospital where he was learning to use the device. She seemed to be having an , but her lungs were clear, so Fox moved the sound-wave probe lower and saw that her abdomen had filled with blood, which he quickly traced to a fetus developing outside her uterus. She was rushed into surgery.

"Without the ultrasound scanner, she would have died from a ruptured ectopic pregnancy," says Fox, co-author and editor of Clinical Emergency Radiology, a new textbook on the use of ultrasound in the ER. "We knew immediately what we needed to do."

Ultrasound has long been a staple of obstetrics. The technology has developed rapidly in recent years, allowing cardiologists, urologists and others to peer inside the body with a clarity that makes minimally invasive surgical techniques, such as heart catheterization and clot removal, safer and more effective. Some scanners, which work by emitting sound waves to plot images on a computer screen, can produce three-dimensional results.

With portable devices that weigh less than 7 pounds, fire up in 15 seconds and cost about $50,000, trained clinicians can identify 44 medical conditions with a high degree of accuracy in two minutes. They can detect collapsed lungs, gallstones, blood clots, heart problems and blockages in the stomach, intestines and kidneys.

When a 40-year-old car crash victim was wheeled into UC Irvine's emergency room recently, his pulse stopped, suggesting heart failure. But by moving the ultrasound probe over the man's chest, Fox saw that blood had flooded the sac surrounding his heart, constricting its ability to pump.

"We cracked his chest open right there and found the cause of the bleeding, which was a hole in the right ventricle," Fox says. "We temporarily closed it, stabilized the patient for more definitive care in the operating room — and he survived."

The scans minimize "the shotgun approach we have had to take in emergency medicine," says Fox, UC Irvine's director of emergency ultrasound and an associate clinical professor who has written 20 peer-reviewed articles and an earlier textbook on the subject.

"We now have the ability to look through the skin, right at the organs we're interested in," he adds. "We can see tears in tissue, in muscles and tendons. Not since the stethoscope have we been able to find out what's going on inside the body without something more invasive, like X-rays. With ultrasound, there's no radiation, just sound waves."

U.S. military medics already have battery-operated ultrasound machines on the battlefield. NASA astronauts have them on the space shuttle. And researchers at remote Antarctic stations are being trained to use them.

Yet only a few hospital emergency rooms in Orange County — indeed, in Southern California — use ultrasound for diagnosis, Fox says.

He credits UC Irvine's director of emergency medicine, Dr. Mark Langdorf, with the foresight to send him almost a decade ago to the Chicago ultrasound program, where Fox became the nation's third ER physician to specialize in emergency radiology. Today there are 44 emergency radiology fellowship programs, including UC Irvine's.

When not in the ER or teaching, Fox is spreading the word about diagnostic ultrasound. He has given lectures in seven countries, 47 states and throughout Southern California

Fox won't be satisfied until ambulances carry ultrasound scanners. "The next step," he says, "is to push this equipment out into the field, with the paramedics, pre-hospital."

Provided by UC Irvine

Explore further: ALS Ice Bucket Challenge arrives in North Korea

add to favorites email to friend print save as pdf

Related Stories

New 3-D ultrasound could improve stroke diagnosis, care

Apr 24, 2008

Using 3-D ultrasound technology they designed, Duke University bioengineers can compensate for the thickness and unevenness of the skull to see in real-time the arteries within the brain that most often clog up and cause ...

Computer model improves ultrasound image

Nov 04, 2008

Doctors use diagnostic sonography or ultrasound to visualise organs and other internal structures of the human body. Dutch researcher Koos Huijssen has developed a computer model that can predict the sound transmission of ...

3-D ultrasound scanner provides in-depth view of the brain

Jun 20, 2007

Biomedical engineers at Duke's Pratt School of Engineering have adapted a three-dimensional ultrasound scanner that might guide minimally invasive brain surgeries and provide better detection of a brain tumor’s location.

Recommended for you

ALS Ice Bucket Challenge arrives in North Korea

Aug 31, 2014

It's pretty hard to find a novel way to do the ALS Ice Bucket Challenge by now, but two-time Grammy-winning rapper Pras Michel, a founding member of the Fugees, has done it—getting his dousing in the center ...

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

User comments : 0