BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation. A secondary outcome was whether paramedics could correctly identify cardiac activity or the lack thereof in cardiac arrest patients. METHODS: We performed a prospective educational study using a convenience sample of professional paramedics without ultrasound experience. Eligible paramedics participated in a 3-hour session on point-of-care US. The paramedics then used US during emergency calls and saved the scans for possible cardiac complaints including: chest pain, dyspnea, loss of consciousness, trauma, or cardiac arrest. RESULTS: Four paramedics from two distinct fire stations enrolled a total of 19 unique patients, of whom 17 were deemed adequate for clinical decision making (89%, 95%CI 67%-99%). Paramedics accurately recorded 17 cases of cardiac activity (100%, 95%CI 84%-100%) and 2 cases of cardiac standstill (100%, 95%CI 22%-100%). CONCLUSION: Our pilot study suggests that with minimal training, paramedics can use US to obtain cardiac images that are adequate for interpretation and diagnose cardiac standstill. Further large-scale clinical trials are needed to determine if prehospital US can be used to guide care for patients with cardiac complaints.
BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation. A secondary outcome was whether paramedics could correctly identify cardiac activity or the lack thereof in cardiac arrestpatients. METHODS: We performed a prospective educational study using a convenience sample of professional paramedics without ultrasound experience. Eligible paramedics participated in a 3-hour session on point-of-care US. The paramedics then used US during emergency calls and saved the scans for possible cardiac complaints including: chest pain, dyspnea, loss of consciousness, trauma, or cardiac arrest. RESULTS: Four paramedics from two distinct fire stations enrolled a total of 19 unique patients, of whom 17 were deemed adequate for clinical decision making (89%, 95%CI 67%-99%). Paramedics accurately recorded 17 cases of cardiac activity (100%, 95%CI 84%-100%) and 2 cases of cardiac standstill (100%, 95%CI 22%-100%). CONCLUSION: Our pilot study suggests that with minimal training, paramedics can use US to obtain cardiac images that are adequate for interpretation and diagnose cardiac standstill. Further large-scale clinical trials are needed to determine if prehospital US can be used to guide care for patients with cardiac complaints.
Authors: Robert W Neumar; Charles W Otto; Mark S Link; Steven L Kronick; Michael Shuster; Clifton W Callaway; Peter J Kudenchuk; Joseph P Ornato; Bryan McNally; Scott M Silvers; Rod S Passman; Roger D White; Erik P Hess; Wanchun Tang; Daniel Davis; Elizabeth Sinz; Laurie J Morrison Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: Ashot E Sargsyan; Douglas R Hamilton; Jeffrey A Jones; Shannon Melton; Peggy A Whitson; Andrew W Kirkpatrick; David Martin; Scott A Dulchavsky Journal: J Trauma Date: 2005-01
Authors: A Testa; G A Cibinel; G Portale; P Forte; R Giannuzzi; G Pignataro; N Gentiloni Silveri Journal: Eur Rev Med Pharmacol Sci Date: 2010-02 Impact factor: 3.507
Authors: T M Scalea; A Rodriguez; W C Chiu; F D Brenneman; W F Fallon; K Kato; M G McKenney; M L Nerlich; M G Ochsner; H Yoshii Journal: J Trauma Date: 1999-03
Authors: Pia Iben Pietersen; Søren Mikkelsen; Annmarie T Lassen; Simon Helmerik; Gitte Jørgensen; Giti Nadim; Helle Marie Christensen; Daniel Wittrock; Christian B Laursen Journal: Scand J Trauma Resusc Emerg Med Date: 2021-02-25 Impact factor: 2.953
Authors: Jacob H Schoeneck; Ryan F Coughlin; Cristiana Baloescu; David C Cone; Rachel B Liu; Sharmin Kalam; Amanda K Medoro; Ian Medoro; Daniel Joseph; Kevin Burns; Jesse I Bohrer-Clancy; Christopher L Moore Journal: West J Emerg Med Date: 2021-03-24