A Pilot Study Examining the Viability of a Prehospital Assessment with UltraSound for Emergencies (PAUSE) Protocol

Chin, Eric J.; Chan, Connie H.; Mortazavi, Rod; Anderson, Craig L.; Kahn, Christopher A.; Summers, Shane M.; Fox, J. Christian

doi:10.1016/j.jemermed.2012.02.032

Cited by 78 publications

(71 citation statements)

References 15 publications

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“…8 Numerous studies have shown that competence in such PoCUS protocols, including the Focused Assessment with Sonography for Trauma 9 and Prehospital Assessment with Ultrasound for Emergencies 10 can be achieved after short intensive training. The Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol, previously described by Atkinson et al in 2009, 11 is a structured six-view PoCUS approach for patients in shock (Figure 1).…”

Section: Résumémentioning

confidence: 99%

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Parks

Verheul

LeBlanc-Duchin

et al. 2015

CJEM

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Background: Goal-directed point-of-care ultrasound (PoCUS) protocols have been shown to improve the diagnostic accuracy of the initial clinical assessment of the critically ill patient. The diagnostic impact of the Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol was assessed in simulated emergency medical scenarios. Methods: Following a focused PoCUS training program, the diagnostic accuracy, confidence, and precision of 12 medical learners participating in standardized scenarios were tested using high-fidelity clinical and ultrasound simulators. Participants were assessed during 72 simulated cardiorespiratory scenarios. Differential diagnoses were collected from participants before and after PoCUS in each scenario, and confidence surveys were completed. Data were analysed using R software. Results: Prior to PoCUS, 45 (62.5%) correct primary diagnoses were made compared with 64 (88.9%) following PoCUS (χ 2 = 14, 1df, p = 0.0002).PoCUS was also shown to increase

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Section: Résumémentioning

confidence: 99%

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Parks

Verheul

LeBlanc-Duchin

et al. 2015

CJEM

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“…Medical schools have integrated ultrasound into their teaching curriculum, and students are using it from basic anatomy to advanced imaging as an adjunct to diagnosis and physical examination [11,12]. The use of POCUS in the pre-hospital setting is also increasing as an aid to early diagnosis and medical decision-making [13].…”

Section: Introductionmentioning

confidence: 99%

Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management

et al. 2014

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Background Point of care ultrasound (POCUS) is a useful diagnostic tool in medicine. POCUS provides an easy and reproducible method of diagnosis where conventional radiologic studies are unavailable. Telemedicine is also a great means of communication between educators and students throughout the world. Hypothesis Implementing POCUS with didactics and hands-on training, using portable ultrasound devices followed by telecommunication training, will impact the differential diagnosis and patient management in a rural community outside the United States. Materials and methods This is an observational prospective study implementing POCUS in Las Salinas, a small village in rural western Nicaragua. Ultrasound was used to confirm a diagnosis based on clinical exam, or uncover a new, previously unknown diagnosis. The primary endpoint was a change in patient management. International sonographic instructors conducted didactic and practical training of local practitioners in POCUS, subsequently followed by remote guidance and telecommunication for 3 months. Results A total of 132 patients underwent ultrasound examination. The most common presentation was for a prenatal exam (23.5 %), followed by abdominal pain (17 %). Of the 132 patients, 69 (52 %) were found to have a new diagnosis. Excluding pregnancy, 67 patients of 101 (66 %) were found to have a new diagnosis. A change in management occurred in a total of 64 (48 %) patients, and 62 (61 %) after excluding pregnancy. Conclusion Implementing POCUS in rural Nicaragua led to a change in management in about half of the patients examined. With the appropriate training of clinicians, POCUS combined with telemedicine can positively impact patient care.Keywords Point of care ultrasound Á Rural medicine Á Telemedicine Sommario Background La diagnostica ecografica (POCUS) é un utile strumento diagnostico in medicina. Fornisce un metodo semplice e riproducibile di diagnosi, dove studi radiologici convenzionali non siano disponibili. Anche la telemedicina é un grande mezzo di comunicazione tra docenti e studenti di tutto il mondo. Ipotesi L'implementazione della POCUS con formazione didattica diretta, utilizzando ecografi portatili, seguita da una formazione attraverso la telecomunicazione, avrà un impatto nella diagnosi differenziale e nella gestione del paziente in una comunità rurale fuori degli Stati Uniti. Materiali e Metodi Presentiamo uno studio prospettico sull'implementazione della POCUS a Las Salinas, un piccolo villaggio rurale del Nicaragua occidentale. L'ecografia è stata utilizzata per confermare la diagnosi clinica, o per nuove diagnosi. Il punto primario era un cambiamento nella gestione del paziente. Istruttori internazionali hanno condotto una formazione didattica pratica locale, poi seguita da una guida a distanza con telecomunicazione, per tre mesi. Risultati Un totale di 132 pazienti sono stati sottoposti ad esame ecografico. L'esame più comune era per la diagnostica prenatale (23,5 %), seguito dal dolore addominale (17 %). Dei 132 pazienti, 69 (52 %) h...

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“…With thorough training and close supervision, medics can adequately obtain and interpret prehospital ultrasound images [23]. A simulation trial demonstrated that ultrasound-naive practitioners were able to achieve an acceptable standard of competency in a relatively short period of time for both acquisition and interpretation of images [24]. This study included training in assessment of the pleural line for pneumothorax, pericardial effusion identification and cardiac activity analysis.…”

Section: Prehospital Emergency Medical Servicesmentioning

confidence: 99%

Out of hospital point of care ultrasound: current use models and future directions

Nelson

Sanghvi

2015

Eur J Trauma Emerg Surg

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Prehospital ultrasound has the ability to increase diagnostic ability and allow for therapeutic intervention in the field. In austere environments, ultrasound may be the only available imaging modality and thus can guide diagnosis, therapeutics and determine which patients may need emergent transfer to a healthcare facility. The most cutting edge applications of portable ultrasound employ telemedicine to obtain and transmit ultrasound images. This technology and ability to transmit images via satellite and cellular transmission can allow for even novice users to obtain interpretable images in austere environments. Portable ultrasound uses have steadily grown and will continue to do so with the introduction of more portable and durable technologies. As applications continue to grow, certain technologic considerations and future directions are explored.

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A Pilot Study Examining the Viability of a Prehospital Assessment with UltraSound for Emergencies (PAUSE) Protocol

Cited by 78 publications

References 15 publications

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management

Out of hospital point of care ultrasound: current use models and future directions

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