POCUS in Emergency Medicine: Dispatches from Iraqi Kurdistan

January 24, 2018

Medical imaging offers life-saving insights into patient health—and perhaps no other imaging modality is more versatile and mobile than point-of-care ultrasound

In a fascinating dispatch from the Kurdish city of Duhok in northern Iraq, Dr. Christine Butts describes how point-of-care ultrasound is an indispensable tool for emergency physicians, especially when patients arrive unconscious and with no indication of an obvious malady.

"The volume of patients has been high at Emergency Hospital. At the height of the war in Mosul, the physicians reported receiving more than 100 injured patients per day, and they regularly relied on the FAST exam to determine the severity of injuries. Other imaging modalities, such as x-ray, CT, and MRI were available, but the large number of patients made triaging their use more challenging. Dr. Ibrahim and his trainees, Drs. Heleen Aqrawi, Ruj Al-Sindy, and Mahmood Sh Hafdullah, related many cases in which a quick FAST exam identified injuries ranging from pneumothorax to intraperitoneal bladder rupture.

The use of ultrasound in Emergency Hospital has now expanded from FAST exams to nerve blocks (particularly femoral nerve blocks) and the RUSH exam for undifferentiated shock. One area in which ultrasound has proved to be useful is in evaluating distal radius fractures, especially in pregnant women, because x-rays are at times viewed with suspicion. Bedside ultrasound is popular with the patients, as it is in the United States, and many patients ask for a scan for reassurance."

Continue reading about how physicians in Kurdistan are embracing ultrasound imaging as a fast, reliable tool for diagnosing and treating their patients.


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