​Point-of-Care Ultrasound (POCUS) practices in the Helicopter Emergency Medical Services in Europe

Abstract

Background: The extent to which Point-of-care of ultrasound (POCUS) is used in different European helicopter EMS (HEMS) is unknown. We aimed to study the availability, perception, and future aspects of POCUS in the European HEMS. Methods: A survey about the use of POCUS in HEMS was conducted by a multinational steering expert committee and was carried out from November 30, 2020 to December 30, 2020 via an online web portal. Invitations for participation were sent via email to the medical directors of the European HEMS organizations including two reminders. Results: During the study period, 69 participants from 25 countries and 41 different HEMS providers took part in the survey. 96% (n=66) completed the survey. POCUS was available in 75% of the responding HEMS organizations when needed (56% always, and 19% occasionally). 17% were planning to establish POCUS in the near future. Responders who provided POCUS used it in approximately 15% of the patients. Participants thought that POCUS is important in both trauma and non-trauma-patients (73%, n=46). The extended focused assessment sonography for trauma (eFAST) protocol (77%) was the most common used protocol. A POCUS credentialing process including documented examinations was requested in less than one third of the HEMS organizations.Conclusions: The majority of the HEMS organizations in Europe are able to provide different POCUS protocols in their services. The most used POCUS protocols were eFAST, FATE and RUSH. Despite the enthusiasm for POCUS, comprehensive training and clear credentialing processes are lacking in about two thirds of the European HEMS organizations.

A National Survey of Prehospital Care Services of United Kingdom for Use, Governance and Perception of Prehospital Point of Care Ultrasound

“…The data suggests that the most common prehospital POCUS scans performed are cardiac ultrasound, lung ultrasound, vascular access and FAST. This correlates with previous studies conducted internationally which have shown FAST to be the most common ultrasound study undertaken by HEMS in Europe and elsewhere [17,20,21].…”

“…A 2014 North American cross-sectional convenience survey shows that 4.1% of Emergency Medical Services (EMS) incorporate ultrasonography within their prehospital care [10]. A one-month multinational survey in 2020 reported 75% of European HEMS services were using a POCUS assessment [17]. This comparison may not accurately reflect the current state of POCUS use due to lack of robust studies and data.…”

“…Prehospital POCUS is yet to evidence mortality benefit for patients. In many studies there are perceived benefits, allowing early diagnosis and decreasing time to clinical interventions [17]. There has been evidence found of a beneficial association between patient care through early intervention and expedited diagnosis inhospital POCUS [6,8], however, there is paucity of evidence in the prehospital field.…”

“…There has been evidence found of a beneficial association between patient care through early intervention and expedited diagnosis inhospital POCUS [6,8], however, there is paucity of evidence in the prehospital field. A number of studies have highlighted possible patient harm by delaying CPR in cardiac arrest or increasing pre-hospital scene times, adding to delay in patient transfer [17,20]. This survey scrutinises perceptions of prehospital clinicians and services about the benefits and barriers to prehospital POCUS.…”

Diagnostic ultrasound examinations during evacuation of urgent patients by ambulance helicopters: literature review

“…По данным общеевропейского онлайн опроса резидентов службы HEMS 25 стран, проведенного в 2020 г., УЗИ было доступно в 75 % организаций и использовалось у 15 % как травматологических пациентов, так и без травм. Самым используемым был расширен ный протокол FAST -он применялся в 77 % случаев [16].…”