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Trauma in pregnancy
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
Foetal well-being is extremely difficult to assess in the pre-hospital environment. Foetal heart sounds may be heard with a standard stethoscope or pre-hospital ultrasound, if available, can be used to view the foetal heart. However, neither are reliable; they may delay transport and do not influence the pre-hospital management of the patient. This means that foetal assessment is not indicated in the pre-hospital setting but will need to be performed on arrival to hospital.
Prehospital Ultrasound Diagnosis of Massive Pulmonary Embolism by Non-Physicians: A Case Series
Published in Prehospital Emergency Care, 2023
Aaron E. Robinson, Nicholas S. Simpson, John L. Hick, Johanna C. Moore, Gregg A. Jones, Michael D. Fischer, Seth Z. Bravinder, Kolby L. Kolbet, Robert F. Reardon
The use of prehospital ultrasound is expanding as point-of-care-ultrasound (POCUS) use in emergency medicine continues to grow in popularity and technology can be adapted to the prehospital environment and becomes more affordable (1–4). The literature on the use of prehospital ultrasound is focused on trauma, and is limited, particularly in the American model of prehospital medicine, where paramedics and emergency medical technicians provide the majority care in the field, as opposed to the prehospital physician response typical for Europe (1, 5). It remains to be answered in what conditions prehospital ultrasound use in undifferentiated medical patients is beneficial. We describe four cases of massive pulmonary embolism diagnosed by non-physician prehospital personnel who were trained to perform rapid ultrasound in shock and hypotension (RUSH) (6) exams on critically ill patients as part of either an agency-wide initiative (LifeLink III) or as part of a specialized team (Hennepin EMS).
Ultrasound Use in the Prehospital Setting for Trauma: A Systematic Review
Published in Prehospital Emergency Care, 2021
Christopher B. Mercer, Matthew Ball, Rebecca E. Cash, Madison K. Rivard, Kirsten Chrzan, Ashish R. Panchal
Early studies have demonstrated the feasibility and some potential clinical performance measures of the use of prehospital ultrasound; however, it is unclear to what extent the use of PHUS may impact the diagnosis, treatment, and transport of trauma patients. (9) We conducted a systematic review of prehospital ultrasound for trauma patients including its use by different providers including EMS professionals, physicians, and mixed practitioner teams (physicians, nurses, EMS professionals). The objectives of this article were to examine the use of prehospital ultrasound for trauma patients and the use by different provider types. Specific outcomes of interest were if prehospital ultrasound has been shown to improve providers’ abilities to recognize conditions that can be managed in the prehospital setting, treat these conditions, change transport destinations, or improve overall mortality rates for trauma patients.
Feasibility of Paramedic Performed Prehospital Lung Ultrasound in Medical Patients with Respiratory Distress
Published in Prehospital Emergency Care, 2018
Torben K. Becker, Christian Martin-Gill, Clifton W. Callaway, Francis X. Guyette, Christopher Schott
In summary, our study can be considered a gap analysis that successfully revealed factors limiting the implementation of prehospital ultrasound with currently available technologies ((16,17): 1) technical limitations with currently existing ultrasound devices, such as battery life, display, software and data transmission; 2) image acquisition in practice, considering both training and environmental aspects; and 3) remote interpretation, distinctly different from the usual practice of POCUS by emergency physicians, and the additional training that may be required.