There was no correlation between ETCO2 and the OAA/S score. Using the criteria of an ETCO2 >50 mm Hg, an absolute change >10 mm Hg, or an absent waveform may detect subclinical RD not detected by pulse oximetry alone. The ETCO2 may add to the safety of PS by quickly detecting hypoventilation during PS in the ED.

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In this resting adult population, the TASER X26 CEW did not affect the recordable cardiac electrical activity within a 24-hour period following a standard five-second application. The authors were unable to detect any induced electrical dysrhythmias or significant direct cardiac cellular damage that may be related to sudden and unexpected death proximal to CEW exposure. Additionally, no evidence of dangerous hyperkalemia or induced acidosis was found. Further study in the area of the in-custody death phenomenon to better understand its causes is recommended.

Objectives: The objective was to determine if 9-1-1 paramedics trained in ultrasound (US) could adequately perform and interpret the Focused Assessment Sonography in Trauma (FAST) and the abdominal aortic (AA) exams in the prehospital care environment.Methods: Paramedics at two emergency medical services (EMS) agencies received a 6-hour training program in US with ongoing refresher education. Paramedics collected US in the field using a prospective convenience methodology. All US were performed in the ambulance without scene delay. US exams were reviewed in a blinded fashion by an emergency sonographer physician overreader (PO).Results: A total of 104 patients had an US performed between January 1, 2008, and January 1, 2009. Twenty AA exams were performed and all were interpreted as negative by the paramedics and the PO. Paramedics were unable to obtain adequate images in 7.7% (8 ⁄ 104) of the patients. Eighty-four patients had the FAST exam performed. Six exams (6 ⁄ 84, 7.1%) were read as positive for free intraperitoneal ⁄ pericardial fluid by both the paramedics and the PO. FAST and AA US exam interpretation by the paramedics had a 100% proportion of agreement with the PO.Conclusions: This pilot study shows that with close supervision, paramedics can adequately obtain and interpret prehospital FAST and AA US images under protocol. These results support a growing body of literature that indicates US may be feasible and useful in the prehospital setting. ACADEMIC EMERGENCY MEDICINE2010; 17:624-630 ª 2010 by the Society for Academic Emergency MedicineKeywords: prehospital ultrasound, paramedic ultrasound, trauma care, and ultrasound P oint-of-care (POC) ultrasound (US) has significantly increased in use over the past 20 years. [1][2][3] Multiple studies have shown the efficacy and efficiency of POC US. Some studies have demonstrated improved morbidity and mortality outcomes.3-5 The use of POC US in the prehospital setting is a relatively new application of this medical technology. Small studies have shown utility in military, ground, and helicopter emergency medical services (EMS) in both Europe and the United States. [5][6][7][8][9][10][11][12][13][14][15][16][17] These studies have largely concentrated on US use for trauma evaluation and involve the application of the Focused Assessment Sonography for Trauma (FAST) or an extended FAST examination. Prehospital US use has been more fully described in Germany, France, and Italy than in the United States.

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The authors were unable to detect a significant difference in the level of subclinical RD or the level of sedation by BIS between the two agents. The use of either agent seems to be safe in the ED.

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