SonoStudy: Prehospital Chest Ultrasound matters!

In a recent study published in Journal of Emergency Medicine, there is a high powered study with quite a few patients on whether prehospital chest ultrasound changes management, destination, or intervention. Once again, a great study highlighting how point of care ultrasound should be used by prehospital providers.

“BACKGROUND:

Due to advancements in technology, the use of a portable ultrasound (US) machine in the out-of-hospital setting is increasingly feasible. It has diagnostic and therapeutic advantages and may improve the management and treatment of patients. It can be used in-flight and can be easily taught to flight clinicians who have little previous experience with this modality.

STUDY OBJECTIVES:

The goal of this study was to evaluate the impact of ultrasound chest examinations on the care of patients treated by a Helicopter Emergency Medical Service (HEMS).

METHODS:

Since 2007, portable US has been used by the HEMS of Nijmegen, The Netherlands. Data on every air medical flight are routinely collected in a database. Every portable US examination of the chest performed between 2007 and 2010 was reviewed for this study. Data on patient characteristics, properties of US examinations, US diagnoses, and impact on medical treatment were collected and analyzed.

RESULTS:

Of a total of 2572 patients, 326 portable US examinations of the chest were performed on 281 (11%) patients. The mean duration of a portable US examination was 2.77 (SD 1.30) min, and the duration decreased over time. After the US examination, the plan for treatment changed in 60 (21%) patients. In 10 patients (4%) the plan to place a chest tube was abandoned. In 10 patients (4%) the initially selected destination for definitive care changed, and it changed to a lower-level hospital more often than to a higher-level one. In 9 patients (3%), cardiopulmonary resuscitation was stopped and in 31 patients there were other changes.

CONCLUSION:

Out-of-hospital US examinations can alter and improve treatment decisions and destinations for definitive care.”

SonoParty…&Journal Club… in Northern CA: Stanford, UCSF, UCSF/Fresno, UC Davis, Highland, Kaisers

Prior to leaving for ACEP in Denver, CO there was a gathering (aka “party”) at my home in sunny San Francisco with my friends and colleagues in emergency medicine / emergency ultrasound  - from all of the ultrasound programs in the region – it was amazing… and yes, wine was served! … along with pizza (of course!) We discussed 4 articles as listed below and I took down the US pearls noted from the various physicians who attended: Continue reading

Pre-hospital (paramedic) US: Re-appreciating the Golden Hour…

HAPPY EMS WEEK!!!! We so appreciate all that you do! Along those lines…… and along with many others all over the world in years past, at Stanford there has been a 2-part study being done supervised by Drs. Sarah Williams and Jessica Pierog (PEEPS study) and at UCI supervised by Dr. Chris Fox and others (PAUSE protocol) on the prehospital use/acquisition/ interpretation of emergencies visible by bedside US.  It is evident (an understatement, actually) that US needs to go into our ambulances. Continue reading