How can I obtain an ultrasound?

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Last updated: September 12, 2026 • View editorial policy

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How to Access Ultrasound

Ultrasound can be accessed through multiple pathways depending on your clinical setting: emergency/point-of-care ultrasound performed immediately at bedside by the treating physician, formal consultative ultrasound ordered through radiology departments, or portable ultrasound in remote/prehospital settings.

Access Pathways by Clinical Setting

Emergency and Critical Care Settings

Point-of-care ultrasound should be performed directly by emergency physicians or intensivists at the bedside without requiring radiology consultation 1. This represents a fundamentally different paradigm from traditional consultative ultrasound:

  • Immediate access: Emergency ultrasound is performed, interpreted, and integrated in real-time as dictated by the clinical scenario 1
  • No imaging department conflicts: Emergency ultrasound is an emergency medicine procedure and should not be considered in conflict with exclusive "imaging" contracts 1
  • Separate billing: Should be reimbursed as a distinct billable procedure 1

Available in multiple emergency settings 1:

  • Emergency departments
  • Intensive care units
  • Out-of-hospital/prehospital environments
  • Battlefield and remote locations
  • Space missions
  • Clinic settings

Core Applications Available

11 primary emergency ultrasound applications are immediately accessible 1:

  • Trauma assessment
  • Intrauterine pregnancy evaluation
  • Abdominal aortic aneurysm (AAA)
  • Cardiac evaluation
  • Biliary pathology
  • Urinary tract assessment
  • Deep vein thrombosis (DVT)
  • Soft-tissue/musculoskeletal
  • Thoracic evaluation (pneumothorax, lung pathology)
  • Ocular examination
  • Procedural guidance

Functional Categories

Access ultrasound based on your immediate clinical need 1:

  1. Resuscitative: Direct use during acute resuscitation
  2. Diagnostic: Emergent diagnostic imaging capacity
  3. Symptom-based: Clinical pathway driven by patient presentation (e.g., shortness of breath)
  4. Procedure guidance: Aid for high-risk procedures
  5. Therapeutic/Monitoring: Physiologic monitoring or therapeutic applications

Consultative Ultrasound Access

For comprehensive diagnostic examinations, order formal ultrasound through radiology departments or ultrasound laboratories 1. This traditional pathway differs from emergency ultrasound in timing, scope, and interpretation process.

Remote and Austere Environment Access

Portable ultrasound devices enable access in prehospital and remote settings 2:

  • Handheld ultrasound machines are increasingly durable and portable 3
  • Telemedicine capabilities allow image transmission via satellite or cellular networks 2
  • Virtual guidance systems enable novice operators to obtain diagnostic-quality images using real-time audio/visual tutorials 4

Critical consideration: Out-of-hospital ultrasound requires significant training, equipment, and physician oversight with quality assurance 1

Specific Clinical Scenarios

Respiratory Failure in ICU

Bedside lung ultrasound should be a primary diagnostic modality 5:

  • Sensitivity and specificity exceed 90% for alveolar consolidation 5
  • Diagnostic accuracy exceeds 90% for common etiologies of acute respiratory failure 5
  • No harmful radiation exposure, repeatable examination 3

Pneumothorax Detection

Ultrasound sensitivity (89%) and specificity (99%) exceed chest radiography (30-75%) 5:

  • Perform at bedside using linear high-frequency probe (5-12 MHz)
  • Start at 3rd-4th intercostal space, mid-clavicular line, moving laterally
  • Loss of lung sliding plus lung point confirms diagnosis with 100% specificity 5

Procedural Guidance

Ultrasound guidance significantly improves success rates 1:

  • Central line placement: 97% success vs 33% without ultrasound
  • Reduces procedure time and number of attempts
  • Particularly valuable in difficult patients (obese, hemodynamically unstable, pediatric) 5

Common Pitfalls

  • Don't delay emergency ultrasound waiting for radiology: Point-of-care ultrasound is meant for immediate bedside use 1
  • Don't confuse emergency ultrasound with comprehensive diagnostic exams: Emergency ultrasound is goal-directed and focused, answering specific clinical questions 1
  • Don't assume you need radiology training: Emergency physicians can perform these examinations with appropriate focused training 1, 5
  • Don't forget quality assurance: Especially critical in out-of-hospital settings 1

References

1
Guideline

emergency ultrasound guidelines.

Annals of emergency medicine, 2009

2
Research

Out of hospital point of care ultrasound: current use models and future directions.

European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2016

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.