Emergency medicine has incorporated many techniques borrowed from other specialties into its armamentarium. These include the use of paralytic agents for emergency airway management, anesthetic medications for conscious sedation, proctoscopy and sigmoidoscopy, slit-lamp examination, and fiberoptic laryngoscopy. Conflicts over who should perform and bill for procedures have resulted from crossing specialty boundaries. The current debate over the use of ultrasonography by emergency physicians is another example of such a battle.

Few would disagree that patients believed to have an acute pericardial effusion, an abdominal aortic aneurysm, free peritoneal fluid, or an ectopic pregnancy should have access to ultrasonography. This diagnostic modality has the potential to confirm or exclude these diagnoses accurately, rapidly, and inexpensively, regardless of the time of day the patient presents to the emergency department. As the number of ultrasound technologists and radiologists are insufficient to provide widespread availability of ultrasonography 7 days a week, 24 hours a day, there is a strong impetus for emergency physicians to provide this service.<sup>8 Heller M., Crocco T., Patterson J. , e al. Emergency ultrasound services as perceived by directors of radiology and emergency departments J Emerg Med 1995 ;  13 : 430  [cross-ref]

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In 1990, the American College of Emergency Physicians (ACEP) published a position statement supporting the availability of diagnostic ultrasonography 24 hours a day, 7 days a week, and that emergency ultrasonography should be performed by appropriately trained physicians, including emergency physicians.<sup>1 American College of Emergency Physicians: Council Resolution on Ultrasound. ACEP News, November 1990.

Cliccare qui per andare alla sezione Riferimenti</sup> A similar statement was passed by the Society of Academic Emergency Physicians (SAEM).<sup>19 Society for Academic Emergency Medicine: Ultrasound Policy Statement. SAEM Newsletter, summer 1991.

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