Clinic scan in ER: forensic-pathological implications and report criteria

Ultrasound assessment of the patient referring to the Emergency Department enhances diagnostic accuracy and facilitate decision making about the need for urgent surgery, the need for admittance in Hospital and it may guide physicians in therapeutic strategies and procedures. Numerous studies have reported the emerging role of ultrasound in the assessment of trauma patients and patients suffering from other medical problems in the Emergency Department. Ultrasound is safe, cheap and portable, the investigation is non-invasive and painless, it can be completed in few minutes and should be performed during the initial assessment of the patient in order to answer to selected and simple clinical case-tailored questions. The technique is not difficult to learn and advances in technology are likely to make portable ultrasound increasingly appropriate to Emergency Department of both first and second level and rural clinical practice. Recently, the American College of the Emergency Physicians (ACEP) has firmly supported the concept of emergency ultrasound and has recognized the need for emergency ultrasound imaging on 24-hour basis and that emergency physicians should be able to perform such examinations. Starting from those considerations the Authors analyse medico-legal issues concerning the correct modalities of performing ultrasonographic examinations, medical report, professional responsibility and medical pitfalls and the concept of defensive medicine in the context of the Emergency Department setting.