气候智能诊断医学成像和点护理超声：循证视角

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-06-09 DOI:10.1016/j.jemermed.2025.05.027

Hamid Shokoohi MD, MPH , Andrew S. Liteplo MD , Kristofer Montoya MD , Casey Patnode MD, MPH , Ainsley B. Hutchinson BA , Michael E. Zalis MD , Michael Gottlieb MD , Ali S. Raja MD , Jonathan E. Slutzman MD

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引用次数: 0

摘要

磁共振成像（MRI）和计算机断层扫描（CT）等方式在能源消耗和温室气体（GHG）排放中占不成比例的份额，医院诊断成像对医疗保健的碳排放有很大贡献。虽然临床价值仍然是最重要的，但可持续性必须成为成像决策的一部分。目的：即时超声（POCUS）以其便携性、成本效益和床边效率而闻名，但其对环境的影响仍未得到充分探讨。本综述旨在检查各种成像方式的温室气体排放，并强调POCUS作为一种更环保的替代方案，在更广泛的战略中使诊断成像与全球气候目标保持一致。pocus消耗更少的能源，产生最小的待机排放，并避免了基础设施密集型设置。它还减少了病人运输和延长住院时间的间接能源消耗。生命周期分析支持超声作为一种低排放的选择，具有高便携性，紧凑的设计，更少的一次性废物，电池供电的操作，并且在大多数应用中不需要造影剂。更广泛地整合POCUS，特别是在选定的临床环境中，它可以先于或取代更多的碳密集型模式，提供了减少医疗保健排放的实用策略。当与人工智能（AI）集成、远程超声和管理框架配合使用时，适当使用POCUS可以最大限度地减少不必要的成像，并支持气候智能型实践。结论随着气候危机的加剧，医学影像尤其是MRI和CT对环境的影响已不容忽视。优先考虑超声这种低影响的方式，在适当的情况下作为一线选择，可以减少对高发射成像的依赖，并推进更可持续的气候智能诊断护理方法。该摘要于2024年5月在亚利桑那州凤凰城举行的SAEM24年会上发表。

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Climate-Smart Diagnostic Medical Imaging and Point-of-Care Ultrasound: An Evidence-Based Perspective

Background

Hospital diagnostic imaging significantly contributes to healthcare's carbon emissions, with modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), accounting for a disproportionate share of energy consumption and greenhouse gas (GHG) emissions. While clinical value remains paramount, sustainability must become part of imaging decision-making.

Objectives

Point-of-care ultrasound (POCUS) is known for its portability, cost-effectiveness, and bedside efficiency, but its environmental impact remain underexplored. This review aims to examine GHG emissions across imaging modalities and highlights POCUS as an eco-friendlier alternative within a broader strategy to align diagnostic imaging with global climate goals.

Discussion

POCUS consumes less energy, generates minimal standby emissions, and avoids infrastructure-intensive setups. It also reduces indirect energy use from patient transport and prolonged hospital stays. Life-cycle analyses support ultrasound as a low-emission option, with its high portability, compact design, lower disposable waste, battery-powered operation, and lack of need for contrast agents in most applications. Broader integration of POCUS, particularly in selected clinical settings where it can precede or replace more carbon-intensive modalities, offers a practical strategy to reduce healthcare emissions.

When paired with artificial intelligence (AI) integration, tele-ultrasound, and stewardship frameworks, appropriate POCUS use can minimize unnecessary imaging and support climate-smart practices.

Conclusion

With the escalating climate crisis, the environmental impact of medical imaging particularly from MRI and CT can no longer be ignored. Prioritizing ultrasound, a low impact modality, as the first-line option where appropriate, can reduce reliance on high-emission imaging and advance a more sustainable, climate smart approach to diagnostic care.

Presentation

The abstract was presented at the SAEM24 Annual Meeting, held in Phoenix, Arizona, in May 2024.

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine