Chapter 43
The Role of Ultrasound in Pre-Hospital Care
Tim Harris,
Adam Bystrzycki,
Stefan M. Mazur,
Tim Harris
Search for more papers by this authorAdam Bystrzycki
Search for more papers by this authorStefan M. Mazur
Search for more papers by this authorTim Harris,
Adam Bystrzycki,
Stefan M. Mazur,
Tim Harris
Search for more papers by this authorAdam Bystrzycki
Search for more papers by this authorStefan M. Mazur
Search for more papers by this authorBook Editor(s):James A. Connolly,
Anthony J. Dean,
Beatrice Hoffmann,
Robert D. Jarman,
James A. Connolly
Search for more papers by this authorAnthony J. Dean
Search for more papers by this authorBeatrice Hoffmann
Search for more papers by this authorRobert D. Jarman
Search for more papers by this authorFirst published: 14 July 2017
Summary
Pre-hospital care (PHC) is organised differently across the globe and consists of: primary work or retrieval work. Doctors bring with them a set of advanced skills which may be used to benefit a small cohort of the sickest patients. One such skill is ultrasound (US). This chapter focuses primarily on the primary retrieval role. The role of US in PHC is two-fold: to promote earlier, more accurate diagnoses, so enhancing patient care; and to minimise the risks of procedures. The management of many medical emergencies and traumatic injuries is influenced by early care delivery. The major potential for harm from PHC US is that of increased on-scene time delaying transport to definitive care. PHC US has been shown to alter the disposition or management of trauma patients, and performs better than clinical assessment alone. US studies performed in the pre-hospital arena may be truncated once diagnostic information has been obtained.
Further Reading
- Abboud, P.A., Kendall, J.L. (2004) Ultrasound guidance for vascular access. Emerg. Med. Clin. North Am., 22, 749–773.
- Báez, A.A., Lane, P.L., Sorondo, B., Giráldez, E.M. (2006) Predictive effect of out-of-hospital time in outcomes of severely injured young adult and elderly patients. Prehosp. Disaster Med., 21 (6), 427–430.
- Bair, A., Panacek, E., Wisner, D., et al. (2003) Cricothyroidotomy: a 5-year experience at one institution. J. Emerg. Med., 24, 151–156.
- Beck-Razi N, Fischer D, Michaelson M, Engel A, Gaitini D. (2007) The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war. J. Ultrasound Med., 26, 1149–1156.
- Bickell, W.H., Wall, M.J., Jr, Pepe, P.E., et al. (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N. Engl. J. Med., 331, 1105–1109.
- Blaivas, M., Kuhn, W., Reynolds, B., Brannam, L. (2005) Change in differential diagnosis and patient management with the use of portable ultrasound in a remote setting. Wilderness Environ. Med., 16, 38–41.
- Blaivas, M., Sierzenski, P., Theodoro, D. (2002) Significant hemoperitoneum in blunt trauma victims with normal signs and clinical examination. Am. J. Emerg. Med., 20, 218–221.
- Blaivas, M., Theodoro, D., Sierzenski, P. (2003) Elevated intracranial pressure detected by bedside emergency ultrasound of the optic nerve sheath. Acad. Emerg. Med., 10, 376–381.
- Boulanger, B.R., McLellan, B.A., Brennemann, F.D., Juan, O., Kirkpatrick, A.W. (1999) Prospective evidence of the superiority of a sonography-based algorithm in the assessment of blunt abdominal injury. J. Trauma, 47, 632–637.
- Brain Injury Foundation, American Association of Neurological Surgeons, Joint section on Neurotrauma and Critical Care (2000) Initial Management. J. Neurotrauma, 17, 463–469.
- Busch, M. (2006) Portable ultrasound in pre-hospital emergencies: a feasibility study. Acta Anaesthesiol. Scand., 50 (6), 754–758.
- Byhahn, C., Binbold, T., Zwissler, B., Maier, M., Walcher, F. (2008) Prehospital ultrasound detects pericardial tamponade in a pregnant victim of stabbing assault. Resuscitation, 76, 146–148.
- Cai Leung Tsui, Hin Tat Fung, Kin Lai Chung, V. Chak Wah Kam (2008) Focussed abdominal sonography for trauma in the emergency department for blunt abdominal trauma. Int. J. Emerg. Med., 1, 183–187.
- Chang, R., Amilton, R., Carter, W. (1998) Declining rate of cricothyroidotomy in trauma patients with an emergency medicine residency: implications for skills training. Acad. Emerg. Med., 5, 247–251.
- Chun, R., Kirkpatrick, A., Sirois, M., et al. (2004) Where's the tube? Evaluation of hand-held ultrasound in confirming endotracheal tube placement. Prehosp. Emerg. Care, 19, 366–369.
- Clarke, J.R., Trooskin, S.Z., Doshi, P.J., Greenwald, L., Mode, C.J. (2002) Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes. J. Trauma, 52, 420–425.
- Corral, E., Silva, J., Suarez, R.M., Nunez, J., Cuesta, C. (2007) A successful emergency thoracotomy performed in the field. Resuscitation, 75 (3) 530–533.
- Costantino, T.G., Parikh, A.K., Satz, W.A., Fojtik, J.P. (2005) Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann. Emerg. Med., 46, 456–461.
- Dan, D., Mingsong, L., Jie, T., Xiaobo, W., Zhong, C., Yan, L., Xiaojin, L., Ming, C. (2010) Ultrasonographic applications after mass casualty incident caused by Wenchuan earthquake. J. Trauma, 68 (6), 1417–1420.
- Deakin, C.D. (2007) From agonal to output: An ECG history of a successful pre-hospital thoracotomy. Resuscitation, 75 (3), 525–529.
- Dean, A.J., Ku, B.S., Zeserson, E.M. (2007) The utility of handheld ultrasound in an austere medical setting in Guatemala after a natural disaster. Am. J. Disaster Med., 2 (5), 249–256.
- Do, J.R., McManus, J., Harrison, B. (2006) Use of ultrasonography to avoid an unnecessary procedure in the prehospital combat environment: a case report. Prehosp. Emerg. Care, 10 (4), 502–506.
- Dronen, S., Thompson, B., Nowak, R., Tomlanovich, M. (1982) Subclavian vein catheterization during cardiopulmonary resuscitation: a prospective comparison of the supraclavicular and infraclavicular percutaneous approaches. JAMA, 247, 3227–3230.
- Durston, W., Swartzentruber, R. (2000) Ultrasound guided reduction of the forearm fractures. Am. J. Emerg. Med., 18, 72–77.
- McManus, J.G., Morton, M.L., Crystal, C.S., et al. (2008) Use of ultrasound to assess acute fracture reduction in emergency care settings. Am. J. Disaster Med., 3, 241–247.
- Emerman, C.L., Bellon, E.M., Lukens, T.W., May, T.E., Effron, D. (1990) A prospective study of femoral versus subclavian vein catheterization during cardiac arrest. Ann. Emerg. Med., 19, 26–30.
- Ezri, T., Gewurtz, G., Sessler, D., et al. (2003) Prediction of difficult laryngoscopy in obese patients by ultrasound quantification of anterior neck soft tissue. Anaesthesia, 58, 1111–1114.
- Farrow, G.B. (2001) Portable ultrasound on deployment: A pilot study. ADF Health, 2, 55–58.
- Forster, R., Pillasch, J., Zielke, A., Malewski, U., Rothmund, M. (1992) Ultrasonography in blunt abdominal trauma: influence of the investigator's experience. J. Trauma, 34, 264–269.
- Friese, R.S., et al. (2007) Abdominal ultrasound is an unreliable modality for the detection of hemoperitoneum in patients with pelvic fracture. J. Trauma, 63, 97–102.
- Galetta, S., Byrne, S., Smith, J. (1989) Echographic correlation of optic nerve sheath size and cerebrospinal fluid pressure. J. Clin. Neuropathalmol., 9, 79–82.
- Gerscovich, E., Cronan, M., McGahan, J., et al. (2001) Ultrasonographic evaluation of diaphragmatic motion. J. Ultrasound Med., 20, 597–604.
- Goksu, E., Sayrac, V., Oktay, C., Kartal, M. (2010) How stylet use can effect confirmation of endotracheal tube position using ultrasound. Am. J. Emerg. Med., 28, 32–36.
- Goldfarb, G., Lebrec, D. (1982) Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: an experience based on 1000 attempts. Anesthesiology, 56, 321–323.
- Goletti, O., Ghiselli, G., Lippons, F.V., et al. (1994) The role of ultrasonography in blunt abdominal trauma: results in 250 consecutive cases. J. Trauma, 36, 178–181.
- Graif, M., Stahl-Kent, V., Ben-Ami, T., Strauss, S., Amit, Y., Itzchak, Y. (1988) Sonographic detection of occult bone fractures. Pediatr. Radiol., 18, 383.
- Grechenig, W., Clement, H.G., Fellinger, M., Seggl, W. (1998) Scope and limitations of ultrasonography in the documentation of fractures – an experimental study. Arch. Orthop. Trauma Surg., 117, 368–371.
- Gruessner, R., Mentges, B., Duber, C., Ruckert, K., Rothmund, M. (1989) Sonography versus peritoneal lavage in blunt abdominal trauma. J. Trauma, 29, 242–244.
- Guidance on the use of ultrasound locating devices for placing central venous catheters, September 2002, Technology appraisal 49, http://www.nice.org.uk/nicemedia/live/11474/32461/32461.pdf.
- Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular care: Part 6: Advanced cardiovascular life support: section 3. Adjuvant for oxygenation, ventilation and airway control. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation, 102 (Suppl. 8), 195.
- Gunst, M., Ghaemmaghami, V., Sperry, J., Robinson, M., O'Keeffe, T., Friese, R., et al. (2008) Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care. J. Trauma, 65 (3), 509–516.
- Halberg, M.J., Wweeney, T.W., Owens, W.B. (2009) Bedside ultrasound for verification of shoulder reduction. Am. J. Emerg. Med., 27 (1), 134.e5–e6.
- Hansen, H., Helmke, K. (1997) Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J. Neurosurg., 87, 34–40.
- Härtl, R., Gerber, L.M., Iacono, L., Ni, Q., Lyons, K., Ghajar, J. (2006) Direct transport within an organized state trauma system reduces mortality in patients with severe traumatic brain injury. J. Trauma, 60 (6), 1250–1256; discussion 1256.
- Heegaard, W., Hildebrandt, D., Spear, D., Chason, K., Nelson, B., Ho, J. (2010) Prehospital Ultrasound by Paramedics: Results of Field Trial. Acad. Emerg. Med., 17 (6), 624–630.
- Helmke, K., Hanson, H. (1996) Fundamentals of transorbital sonographic evaluation of the optic nerve sheath expansion under intracranial hypertension, I: experimental study. Pediatr. Radiol., 26, 701–705.
- Helmke, K., Hanson, H. (1996) Fundamentals of transorbital sonographic evaluation of the optic nerve sheath expansion under intracranial hypertension, II: experimental study. Pediatr. Radiol., 26, 706–710.
- Hilty, W.M., Hudson, P.A., Levitt, M.A., Hall, J.B. (1997) Real-time US-guided femoral vein catheterization during cardiopulmonary resuscitation. Ann. Emerg. Med., 29, 331–337.
- Hind, D., Calvert, N., McWilliams, R., Davidson, A., Paisley, S., Beverley, C., et al. (2003) Ultrasonic locating devices for central venous cannulation: meta-analysis. Br. Med. J., 327, 361–367.
- Hoffmann, R., Nerlich, M., Muggia-Sullam, M., et al. (1992) Blunt abdominal trauma in cases of multiple trauma evaluated by ultrasonography: a prospective analysis of 291 patients. J. Trauma, 32, 452–458.
- Holmes, A.E.M., Holmes, J.F., Harris, D., Battistella, F.D. (2004) Performance of abdominal ultrasonography in blunt trauma patients with out-of-hospital or emergency department hypotension. Ann. Emerg. Med., 43 (3), 354–361.
- Hrics, P., Wilber, S., Blanda, M.P., Gallo, U. (1998) US-assisted internal jugular catheterization in the ED. Am. J. Emerg. Med., 16, 401–403.
- Hsieh, K., Lee, C., Lin, C., et al. (2004) Secondary confirmation of endotracheal tube placement by bedside ultrasound. Crit. Care Med., 32 (Suppl.), S374–S377.
- Huffer, L.L., Bauch, T.D., Furgerson, J.L., et al. (2004) Feasibility of remote echocardiography with to support medical activities in the austere medical environment. J. Am. Soc. Echocardiogr., 17, 670–674.
- Jang, T., Audin, C. (2005) The use of serial ocular ultrasound in the care of patients with head injury (letter). Ann. Emerg. Med., 45, 335–336.
- Jastremski, M.S., Matthias, H.D., Randell, P.A. (1984) Femoral venous catheterization during cardiopulmonary resuscitation: a critical reappraisal. J. Emerg. Med., 1, 387–389.
- Jorgensen, H., Jensen, C., Dirks, J. (2010) Does pre-hospital ultrasound improve the treatment of the trauma patient? Eur. J. Emerg. Med., 17, 249–253.
- Keven, K., Ates, K., Yagmurlu, B., et al. (2001) Renal Doppler ultrasonographic findings in earthquake victims with crush injury. J. Ultrasound Med., 20, 675–679.
- Keyes, L.E., Frazee, B.W., Snoey, E.R., Simon, B.C., Christy, D. (1999) US-guided brachial and basilic vein cannulation in emergency department patients with difficult intravenous access. Ann. Emerg. Med., 34, 711–714.
- Kimura, A., Otsuka, T. (1991) Emergency center ultrasonography in the evaluation of hemoperitoneum: a prospective study. J. Trauma, 31, 20–23.
- Knapp, S., Kofler, J., Stoiser, B., et al. (1999) The assessment of four methods to verify tracheal tube placement in the critical care setting. Anesth. Analg., 88, 766–770.
- Lapostolle, F., Petrovic, T., Catineau, J., Lenoir, G., Adnet, F. (2005) Training emergency physicians to perform out-of-hospital ultrasonography (letter). Am. J. Emerg. Med., p. 572.
- Le, A., Hoehn, M., Smith, M., Spentzas, T., Schlappy, D., Pershad, J. (2009) Bedside sonographic measurement of optic nerve sheath diameter as a predictor of increased intracranial pressure in children. Ann. Emerg. Med., 53, 785–791.
- Leigh-Smith, S., Harris, T. (2005) Tension pneumothorax – time for a re-think? Emerg. Med. J., 22, 8–16.
- Leung, J., Duffy, M., Finck, H. (2006) Real-time ultrasonographically-guided internal jugular vein catheterization in the Emergency Department increases success rates and reduces complications: A randomized, prospective study. Ann. Emerg. Med., 48, 540–547.
- Li, J. (2001) Capnography alone is imperfect for endotracheal tube placement confirmation. J. Emerg. Med., 20, 223–229.
- Lichtenstein, D.A. (2007) Ultrasound in the management of thoracic disease. Crit. Care Med., 35 (5 Suppl.), S250–S261.
- Liu, M., Lee, C., P'eng, F.K. (1993) Prospective comparison of diagnostic peritoneal lavage computed tomographic scanning and ultrasonography for the diagnosis of blunt trauma. J. Trauma, 35, 267–270.
- Lockey, D.J., Davies, G. (2007) Pre-hospital thoracotomy: A radical resuscitation intervention come of age? Resuscitation, 75, 394–395.
- Ma, G., Hayden, S., Chan, T., et al. (1999) Using ultrasound to visualise and confirm endotracheal intubation (abstract). Acad. Emerg. Med., 6, 515.
- Ma, O.J., Norvell, J.G., Subramanian, S. (2007) Ultrasound applications in mass casualties and extreme environments. Crit. Care Med., 35 (5 Suppl.), S275–S279.
- Mace, S., Hedges, J. (2004) Cricothyroidotomy and translaryngeal jet ventilation, in Clinical Procedures in Emergency Medicine, 4th edition (eds Roberts and Hedges), WB Saunders, Philadelphia, Chapter 6.
- Mansfield, P.F., Hohn, D.C., Fornage, B.D., Gregurich, M.A., Ota, D.M. (1994) Complications and failures of subclavian-vein catheterization. N. Engl. J. Med., 331, 1735–1738.
- Mazur, S., Pearce, A., Alfred, S., Sharley, P. (2007) Use of point-of-care ultrasound by a critical care retrieval team. Emerg. Med. Austr., 19, 547–552.
- Mazur, S.M., et al. the F.A.S.T.E.R. trial. (2008) Focused assessment by sonography in trauma during emergency retrieval: A feasibility study. Injury Int. J. Care Injured, 39, 512–518.
-
Mazur, S.M., Rippey, J. (2009) Transport and use of point-of-care ultrasound by a Disaster Medical Assistance Team. Prehosp. Disast. Med., 24 (2), 140–144.
10.1017/S1049023X00006701 Google Scholar
- McGahan, J.P., Rose, J., Coates, T.L., Wisner, D.H., Newberry, P. (1997) Use of ultrasonography in the patient with acute abdominal trauma. J. Ultrasound Med., 16, 653–662.
- McKenney, M.G., Martin, L., Lentz, K., et al. (1996) 1,000 consecutive ultrasounds for blunt abdominal trauma. J. Trauma, 40, 607–610.
- McNeil, C.R., McManus, J., Mehta, S. (2009) The accuracy of portable ultrasonography to diagnose fractures in an austere environment. Prehosp. Emerg. Care, 13, 50–52.
-
Melanson, S.W., McCarthy, J., Stromski, C.J., Kostenbader, J., Heller, M. (2006) Aeromedical trauma sonography by flight crews with a miniature ultrasound unit. Prehosp. Emerg. Care, 5, 399–402.
10.1080/10903120190939607 Google Scholar
- Merrer, J., De Jonghe, B., Golliot, F., Lefrant, J., Raffy, B., Barre, E., et al. (2001) Complications of femoral and subclavian venous catheterization in critically ill patients. JAMA, 286, 700–707.
- Miletic, D., Fuckar, Z., Mraovic, B., et al. (1999) Ultrasonography in the evaluation of hemoperitoneum in war casualties. Mil. Med., 164, 600–602.
- Miller, A.H., Roth, B.A., Mills, T.J., et al. (2002) US guidance versus the landmark technique for the placement of central venous catheters in the emergency department. Acad. Emerg. Med., 9, 800–805.
- Farahmand, N., Sirlin, C.B., Brown, M.A., Shragg, G.P., Fortlage, D., Hoyt, D.B., Casola, G. (2005) Hypotensive patients with blunt abdominal trauma: performance of screening US. Radiology, 235, 436–443.
- Nicholls, S., Sweeney, T., Ferre, R., Strout, T. (2008) Bedside sonography by emergency physicians for the rapid identification of the landmarks relevant to cricothyroidotomy. Am. J. Emerg. Med., 26, 852–856.
- Noble, V.E., Lamhaut, L., Capp, R., et al. (2009) Evaluation of a thoracic ultrasound training module for the detection of pneumothorax and pulmonary edema by prehospital physician care providers. BMC Med. Educ., 9, 3.
- Pearce, A., Mark, P., Gray, N., Curry, C. (2006) Responding to the Boxing Day tsunami disaster in Aceh, Indonesia: Western and South Australian contributions. Emerg. Med. Austral., 18, 86–92.
- Polk, J.D., Fallon, W.F. (2000) The use of focussed assessment with sonography for trauma (FAST) by a prehospital air medical team in the trauma arrest patient. Prehosp. Emerg. Care, 4, 82–84.
- Polk, J.D., Fallon, W.F., Kovach, B., Mancuso, C., Stephens, M., Malangoni, M.A. (2001) The ‘airmedical FAST’ for trauma patients – The initial report for a novel application for sonography. Aviat. Space Environ. Med., 72, 432–436.
- Price, D.D., Wilson, M.D., Murphy, T.G. (2000) Trauma ultrasound feasibility during helicopter transport. Air Med. J., 19 (4), 144–146.
- Roberts, J., McManus, J., Harrison, B. (2006) Use of ultrasonography to avoid an unnecessary procedure in the prehospital combat environment: a case report. Prehosp. Emerg. Care, 10, 502–506.
- Rothlin, M.A., Naf, R., Amgwerd, M., Candinas, D., Frick, T., Trentz, O. (1993) Ultrasound in blunt abdominal and thoracic trauma. J. Trauma, 34, 488–495.
- Rozycki, G.S., Ochsner, M.G., Schmidt, J.A., et al. (1995) A prospective study of surgeon-performed ultrasound as the primary adjuvant modality for injured patient assessment. J. Trauma, 39 (3), 492–498.
- Rozycki, G.S., Ochsner, M.G., Jaffin, J.H., Champion, H.R. (1993) Prospective evaluation of surgeons’ use of ultrasound in the evaluation of trauma patients. J. Trauma, 34, 516–526.
- Sarkisian, A.E., Khondkarian, R.A., Amirbekian, N.M., et al. (1991) Sonographic screening of mass casualties for abdominal and renal injuries following the 1988 Armenian earthquake. J Trauma, 31, 247–250.
- Scalea, T.M., Sinert, R., Duncan, A.O., Rice, P., Austin, R., Kohl, L., et al. (1994) Percutaneous central venous access for resuscitation in trauma. Acad. Emerg. Med., 1, 525–531.
- Schmitt, J., Ma, G., Hayden, S., et al. (2000) Suprasternal versus cricothyroid ultrasound probe position in the confirmation of the endotracheal tube placement by bedside ultrasound (abstract). Acad. Emerg. Med., 7, 526.
- Sheridan, R.L., Petras, L., Lydon, M. (1997) Ultrasonic imaging as an adjunct to femoral vein catheterization in children. J. Burn Care Rehabil., 18, 156–158.
- Stone, M.B., Teismann, N.A., Wang, R. (2007) Ultrasound confirmation of intraosseous needle placement in an adult unembalmed cadaver model. Ann. Emerg. Med., 49, 515–519.
- Strode, C.A., Rubal, B.J., Gerhardt, R.T., et al. (2003) Satellite and mobile wireless transmission of focused assessment with sonography in trauma. Acad. Emerg. Med., 10, 1411–1414.
- Sutic, A. (2007) Role of ultrasound in the airway management of critically ill patients. Crit. Care Med., 35 (5), S173–S177.
- Swanson, R.S., Uhlig, P.N., Gross, P.L., McCabe, C.J. (1984) Emergency intravenous access through the femoral vein. Ann. Emerg. Med., 13, 244–247.
- Sznajder, J.I., Zveibil, F.R., Bitterman, H., Weiner, P., Bursztein, S. (1986) Central vein catheterization: failure and complication rates by three percutaneous approaches. Arch. Intern. Med., 146, 259–261.
- Sztajnkrycer, M.D., Baez, A.A., Luke, A. (2006) FAST ultrasound as an adjunct to triage using the START mass casualty triage system: a preliminary descriptive system. Prehosp. Emerg. Care, 10, 96–102.
- Tayal, V., Neulander, M., Norton, H., Foster, T., Saunders, T., Blaivas, M. (2007) Emergency department sonographic measurements of the optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann. Emerg. Med., 49 (4), 508–514.
- Volpicelli, G. (2007) Significance of comet tail artifacts at lung ultrasound. Am. J. Emerg. Med., 25 (8), 981–982.
- Walcher, F., Kirschning, T., Müller, M.P., et al. (2010) Accuracy of prehospital focused abdominal sonography for trauma after a 1-day hands-on training course. Emerg. Med. J., 27, 345–349.
- Walcher, F., Kortüm, S., Kirschning, T., Weihgold, N., Marzi, I. (2002) Optimierung des traumamanagements durch präklinische sonographie. Unfallchirurg, 105, 986–994.
- Walcher, F., Weinlich, M., Conrad, G., Schweigkofler, U., Breitkreutz, R., Kirsching, T., et al. (2006) Prehospital ultrasound imaging improves management of abdominal trauma. Br. J. Surg., 93, 238–242.
- Weaver, B., Lyon, M., Blaivas, M. (2005) Confirmation of endotracheal tube placement after intubation using the ultrasound lung sliding sign. Acad. Emerg. Med., 8, 239–244.
- Weinberg, B., Diakoumakis, E.E., Kass, E.G., Seife, B., Zvi, Z.B. (1986) The air bronchogram: sonographic demonstration. Am. J. Roentgenol., 147 (3), 593–595.
- Weiss, D.B., Jacobson, J.A., Karunakar, M.A. (2005) The use of ultrasound in evaluating orthopaedic trauma patients. J. Am. Acad. Orthop. Surg., 13, 525–533.
- Werner, S., Smith, C., Goldstein, J., Jones, R., Cydulka, R. (2007) Pilot study to evaluate the accuracy of ultrasound in confirming endotracheal tube placement. Ann. Emerg. Med., 49, 75–80.
- Westfall, M.D., Price, K.R., Lambert, M., Himmelman, R., Kacey, D., Dorevitch, S., et al. (1994) Intravenous access in the critically ill trauma patient: a multicentered, prospective, randomized trial of saphenous cutdown and percutaneous femoral access. Ann. Emerg. Med., 23, 541–545.
- Yuen, C.K., Mok, K.L., Kan, P.G., Wong, Y.T. (2009) Bedside ultrasound for the verification of shoulder reduction with lateral and anterior approaches. Am. J. Emerg. Med., 27, 503–504.
- Yuen, C.K., Mok, K.L., Kan, P.G., Wong, Y.T. (2009) Ultrasound diagnosis of anterior shoulder dislocation. Hong Kong J. Emerg. Med., 16 (1), 29–34.
