Some recent legal cases in emergency medicine
To give you a sense of some of the things that can happen if you don't use ultrasound, there are a couple recent legal cases that were actually in Moore's medical legal report, this is no relation to me, but it talks about two cases in the same newsletter. One is a patient that came in with a diabetic emergency - the ED physician put in a femoral line, it was later recognized in the ICU to be in the artery and resulted in amputation. The verdict was actually for the defense, they said this was a known complication and the amputation was a result of underlying chronic disease, but the plaintiff had claimed that they should have used ultrasound when placing it. Another case talks about shock and attempts at obtaining subclavian access in a patient that ended up lacerating the subclavian vein and caused the death of the patient. The plaintiff stated they didn't recognize this and didn't act fast enough. Again, the defense said this was a known complication and it was a verdict for the defense. Just because these cases came out for the defense does mean this is the best thing for the patient. I would argue that ultrasound can really help you do things better, faster, more efficiently, and safer particularly with vascular access.