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Visualized Precision Diagnosis and Treatment: Application of Handheld Ultrasound in Emergency Medicine

Visualized Precision Diagnosis and Treatment: Application of Handheld Ultrasound in Emergency Medicine

Emergency care emphasizes seizing every second and acting at the first opportunity. For traumatic emergency care, the first few minutes to hours after injury are the optimal treatment window. Rapid assessment and treatment can reduce mortality and improve outcomes. With the continuous improvement of aging in China, the demand for emergency care for critical and severe illnesses has also increased accordingly.

Modern emergency care mainly consists of three parts: pre-hospital emergency care, continuous treatment in the emergency department, and more comprehensive treatment in the critical care unit (ICU, CCU).

The on-site environment of pre-hospital emergency care is complex, and the patients received are diverse. In emergency scenes, it is difficult to detect problems at the first time through early physical examination, so that many critically ill patients do not receive effective treatment before being admitted to the hospital, resulting in delayed condition. Handheld ultrasound devices are particularly useful in such cases. The SonoMaxx handheld ultrasound is light in weight, small in size and easy to carry. In limited space, it can assist emergency personnel in quickly assessing the patient’s condition or injury, performing rescue, providing nursing care, transferring the patient and monitoring the condition during transportation.

The picture shows the SonoMaxx handheld ultrasound participating in rescue operations during the Beijing Winter Olympics.
The picture shows the SonoMaxx handheld ultrasound participating in rescue operations during the Beijing Winter Olympics.The application of ultrasound technology enables rapid, real-time, dynamic and repeatable assessment of patients’ conditions, and guides the implementation of effective treatment. Rapid assessment, early diagnosis and timely intervention of critical illnesses are challenges that emergency physicians must face. Point-of-care ultrasound (POCUS) provides emergency physicians with an increasing amount of clinical information about critically ill patients, and is hailed as a visual “stethoscope”.

The main clinical applications of ultrasound in pre-hospital emergency care are as follows:

Trauma Assessment (FAST)
 Lung Ultrasound
Focused Emergency Cardiac Assessment
Focused Emergency Abdominal Assessment
 Lower Extremity Deep Venous Thrombosis (DVT)
 Focused Ultrasound in Emergency Obstetrics and Gynecology
 Ultrasound-Guided Venipuncture
 Rib Fracture Examination
 ……

Trauma Assessment (FAST)

Injuries to abdominal and pelvic organs are the leading cause of early death in severe trauma. For uncontrollable bleeding, early diagnosis and emergency laparotomy are often the only chance for patients to survive. The handheld ultrasound is plug-and-play, allowing emergency personnel to complete a quick scan in 3–5 minutes.
Clinical Image Examples of Handheld Ultrasound Abdominal Scanning

Examination of Pulmonary Diseases

Dyspnea is a common acute condition in pre-hospital emergency care, and diagnostic tools for it are often limited. Lung ultrasound has high diagnostic value in differentiating between pulmonary edema and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).
BLUE Protocol
The SonoMaxx handheld ultrasound is equipped with dedicated lung presets that can be accessed with one click to ensure optimal image quality. Meanwhile, it is integrated with an AI system and B-Lines, an intelligent software dedicated to pneumonia. By intelligently identifying B-lines in lung images, detecting the number and spacing of B-lines, it provides intelligent prompts for different lung diseases, enabling rapid examination of pulmonary conditions.

DVT/Deep Venous Thrombosis

Deep venous thrombosis (DVT) is a venous reflux disorder caused by abnormal blood coagulation in the deep veins, which mostly occurs in the lower extremities; thrombus detachment can lead to pulmonary embolism.Dyspnea is a common acute condition in pre-hospital emergency care, and diagnostic tools for it are often limited. Lung ultrasound has high diagnostic value in differentiating between pulmonary edema and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).

Cardiac Examination

The three main goals of Focused Emergency Cardiac Ultrasound Assessment for patients presenting with acute dyspnea/shortness of breath are as follows:
1) To determine the presence of pericardial effusion
2) To assess global left ventricular systolic function
3) To assess the size of the right ventricle

Clinical Image Examples of Handheld Ultrasound Cardiac Scanning

Inferior Vena Cava Diameter and Volume Status

The inferior vena cava is a main trunk vein that collects venous blood from the lower extremities, pelvis, and abdominal cavity, passes through the vena cava foramen of the diaphragm after traversing the vena cava fossa of the liver, and finally drains back into the heart, belonging to the category of central veins.
Ultrasound examination of the inferior vena cava is increasingly applied in critically ill patients with cardiovascular diseases, and it plays an important role in the decision-making of fluid resuscitation for diseases such as heart failure, cardiogenic shock, and sepsis shock-related myocardial depression.

Clinical Image Examples of Handheld Ultrasound Abdominal Scanning

Emergency Lesions in Obstetrics and Gynecology

Ectopic pregnancy, hydatidiform mole, abortion, placenta previa, placental abruption, pregnancy complicated with pelvic tumors and other special emergency conditions in obstetrics and gynecology can be rapidly screened by ultrasound.

Ultrasound-guided Venipuncture

Ultrasound can clearly display the deep tissue structures of the human body, accurately locate the target, and observe the dynamic changes of the target in real time, thereby avoiding serious complications. The puncture guide line and puncture enhancement functions of the handheld ultrasound can help doctors improve the success rate of one-time puncture, reduce puncture time, enhance efficiency, and alleviate patient suffering.
Handheld Ultrasound-guided Puncture
SonoMaxx handheld ultrasound is available in multiple models, which can basically cover whole-body examinations. Meanwhile, the handheld ultrasound is equipped with a 5G remote system, allowing emergency physicians to transmit the ultrasound information obtained pre-hospital back to the hospital in real time. The information arrives before the patient, which helps the hospital to prepare personnel, equipment and treatment plans in advance, enabling patients to receive high-quality and efficient treatment.
Handheld ultrasound supports 5G remote connectivity
With the development of ultrasound technology and the increasing clinical demand for professional and precise medical care, SonoMaxx handheld ultrasound has so far received a great deal of feedback in the field of acute and critical care. It is of great help for the rapid diagnosis and treatment as well as qualitative assessment of patients, assisting emergency physicians in performing immediate bedside ultrasound examinations on patients, and adjusting diagnosis and treatment measures in a timely manner based on monitoring results and monitoring treatment effects. Bedside emergency ultrasound has become one of the indispensable and important diagnostic tools in the emergency department.

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