Use of prehospital ultrasound in North America: A survey of emergency medical services medical directors

被引：34

作者：

Taylor J. ^{[1
,2
]}

McLaughlin K. ^{[3
]}

McRae A. ^{[3
]}

Lang E. ^{[3
]}

Anton A. ^{[3
,4
]}

机构：

[1] University of Calgary MD program, Vancouver, BC V6J 4V4

[2] University of British Columbia, Department of Emergency Medicine, Vancouver

[3] University of Calgary Division of Emergency Medicine, Calgary

[4] Alberta Health Services EMS Calgary zone, Calgary

来源：

BMC Emergency Medicine | / 14卷 / 1期

关键词：

Emergency medical services; Ultrasonography;

D O I：

10.1186/1471-227X-14-6

中图分类号：

学科分类号：

摘要：

Background: Advances in ultrasound imaging technology have made it more accessible to prehospital providers. Little is known about how ultrasound is being used in the prehospital environment and we suspect that it is not widely used in North America at this time. We believe that EMS system characteristics such as provider training, system size, population served, and type of transport will be associated with use or non-use of ultrasound. Our study objective was to describe the current use of prehospital ultrasound in North America.Methods: This study was a cross-sectional survey distributed to EMS directors on the National Association of EMS Physicians (NAEMSP) mailing list. Respondents had the option to complete a paper or electronic survey.Results: Of the 755 deliverable surveys we received 255 responses from across Canada and the United states for an overall response rate of 30%. Of respondents, 4.1% of EMS systems (95% CI 1.9, 6.3) reported currently using ultrasound and an additional 21.7% (95% CI 17, 26.4) are considering implementing ultrasound. EMS services using ultrasound have a higher proportion of physicians (p < 0.001) as their highest trained prehospital providers when compared to the survey group as a whole. The most commonly cited current and projected applications are Focused Abdominal Sonography for Trauma (FAST) and assessment of pulseless electrical activity (PEA) arrest. The cost of equipment and training are the most significant barriers to implementation of ultrasound. Most medical directors want evidence that prehospital ultrasound improves patient outcomes prior to implementation.Conclusions: Prehospital ultrasound is infrequently used in North America and there are a number of barriers to its implementation, including costs of equipment and training and limited evidence demonstrating improved outcomes. A research agenda for prehospital ultrasound should focus on patient-important outcomes such as morbidity and mortality. Two commonly used indications that could be a focus of standardized training programs are the FAST exam, and assessment of PEA arrest. © 2014 Taylor et al.; licensee BioMed Central Ltd.

引用

共 30 条

[1]

Rognas L.K., Christensen E.F., Sloth E., Bendtsen T.F., Prehospital ultrasound, Ugeskr Laeger, 171, 36, pp. 2545-2547, (2009)

[2]

Walcher F., Weinlich M., Conrad G., Schweigkofler U., Breitkreutz R., Kirschning T., Marzi I., Prehospital ultrasound imaging improves management of abdominal trauma, Br J Surg, 93, 2, pp. 238-242, (2006)

[3]

Hoyer H.X., Vogl S., Schiemann U., Haug A., Stolpe E., Michalski T., Prehospital ultrasound in emergency medicine: Incidence, feasibility, indications and diagnoses, Eur J Emerg Med, 17, 5, pp. 254-259, (2010)

[4]

Mazur S.M., Pearce A., Alfred S., Goudie A., Sharley P., The F.A.S.T.E.R trial focused assessment by sonography in trauma during emergency retrieval: A feasibility study, Injury, 39, 5, pp. 512-518, (2008)

[5]

Brooke M., Walton J., Scutt D., Connolly J., Jarman B., Acquisition and interpretation of focused diagnostic ultrasound images by ultrasound-naive advanced paramedics: trialling a PHUS education programme, Emerg Med J, 29, 4, pp. 322-326, (2011)

[6]

Heegaard W., Hildebrandt D., Spear D., Chason K., Nelson B., Ho J., Prehospital ultrasound by paramedics: results of field trial, Acad Emerg Med, 17, 6, pp. 624-630, (2010)

[7]

Walcher F., Kortum S., Kirschning T., Weihgold N., Marzi I., Optimized management of polytraumatized patients by prehospital ultrasound, Unfallchirurg, 105, 11, pp. 986-994, (2002)

[8]

Jorgensen H., Jensen C.H., Dirks J., Does prehospital ultrasound improve treatment of the trauma patient? A systematic review, Eur J Emerg Med, 17, 5, pp. 249-253, (2010)

[9]

Brooke M., Walton J., Scutt D., Paramedic application of ultrasound in the management of patients in the prehospital setting: a review of the literature, Emerg Med J, 27, 9, pp. 702-707, (2010)

[10]

Nelson B., Chason K., Use of ultrasound by emergency medical services: a review, Int J Emerg Med, 1, 4, pp. 253-259, (2008)

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