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Penetrating the acoustic shadows: emergency ultrasound in South African emergency departments.

The introduction of emergency medicine as a new speciality in South Africa brought with it the tools and experience from countries where emergency medicine has been practiced for many years. With an ever increasing evidence base, emergency ultrasound is one of the tools soon to be introduced to South African emergency departments. As with any diagnostic apparatus there are areas where its use is more helpful and areas where it is not. Successful emergency ultrasound depends on binary (yes/no) decisions covering specified areas of emergency medicine where life and death decisions are to be made (i.e. trauma, abdominal aortic aneurism and cardiac arrest). As its introduction is likely to change the more established treatment options this has brought about some discussion about safety, alternatives and who should be doing it. Given the large volume of generalists employed in the emergency medicine sector this, as elsewhere, is unlikely to be radiologists. This paper evaluates the evidence and references the current policies of countries where emergency ultrasound practiced by non-radiologists is considered established.