Paramedic application of ultrasound in the management of patients in the prehospital setting: a review of the literature

Abstract

The theoretical concept that paramedic-initiated prehospital ultrasound may be of benefit in the management of critically ill patients is not without logical conceptual reason. Studies to date have demonstrated that with the right education and mentorship, some paramedic groups are able to obtain ultrasound images of sufficient quality to positively identify catastrophic pathologies found in critically ill patients. More research is required to demonstrate that these findings are transferable to the infrastructure of the UK EMS, and in what capacity they may be used to help facilitate optimal patient outcomes.

Training paramedics in focussed echo in life support

“…It is a noninvasive, quick and easy examination that can provide ongoing information about a patient's condition and is well established in the European system of physician-led prehospital care [7]. Critically, it can provide information related to a reversible aetiology for CA or identify the presence of subtle cardiac function when a pulse is not detected.…”

“…It is a user-dependent technique and relies upon an operator's ability to capture and interpret images [7]. In the context of a CA, ultrasound has a very narrow window of use and must be performed in the 10-s pulse check to ensure that chest compressions are not interrupted [6].…”

“…There is little evidence surrounding the success of training paramedics to undertake focused ultrasound examinations, as well as on whether these skills could be maintained through their current opportunities for operational exposure in the field [7]. Several studies have tested the feasibility of paramedicconducted ultrasound, which is overseen by a physician based at the receiving hospital.…”

Prehospital ultrasound of the abdomen and thorax changes trauma patient management: A systematic review

“…Training in the use of PHUS has been considered a limitation [19] and is considered a challenge by previous reviews [47,52,53]. Studies have found PHUS training to be feasible both with physicians [54,55] and non-physicians [53,[56][57][58][59][60].…”

“…Studies have found PHUS training to be feasible both with physicians [54,55] and non-physicians [53,[56][57][58][59][60]. Nonphysician use of PHUS in changing patient management has not been studied.…”