Robotic ultrasound scanning in real clinical environments requires both high-level clinical workflow reasoning and low-level closed-loop execution. Physicians natural-language instructions often contain implicit anatomical targets, procedural logic, image-quality requirements, and safety constraints, while execution is affected by patient motion, contact variations, and target drift. We propose a fast and slow hierarchical embodied ultrasound system for safe and interpretable robotic ultrasound assistance. The Slow Brain performs intent parsing and stage-wise task planning with knowledge augmentation from an API and handbook corpus, and generates executable plans through task-graph construction and structured plan verification. The Fast Brain fuses multimodal feedback, including ultrasound images, robot pose and force states, and patient-motion information, to refine local actions and perform image-quality-guided recovery behaviors. The system further integrates a Safety Shield and a hierarchical escalation policy to constrain risky actions and trigger replanning or human confirmation under persistent failures or safety-bound violations. Experiments on planning evaluation, closed-loop execution under dynamic perturbations, and safety-mechanism validation demonstrate that the proposed hierarchical design improves task success rates while reducing safety violations.

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