Prehospital Emergency Ultrasound: A Review of Current Clinical Applications, Challenges, and Future Implications

Abstract

Imaging modalities in the prehospital setting are helpful in the evaluation and management of time-sensitive emergency conditions. Ultrasound is the main modality that has been applied by emergency medical services (EMS) providers in the field. This paper examines the clinical applications of ultrasound in the prehospital setting. Specific focus is on applications that provide essential information to guide triage and management of critical patients. Challenges of this modality are also described in terms of cost impact on EMS agencies, provider training, and skill maintenance in addition to challenges related to the technical aspect of ultrasound.

Early identification of aortic dissection with pre-hospital ultrasound: a case report.

“…Some articles and reviews have tried to clarify this point, and according to them, we can suggest three major indications: trauma (FAST or EFAST) [9,10], CPR (FEEL protocol) [11], and respiratory insufficiency (LUS) [2,12].…”

“…For example, the FAST is focused on the identification of free fluid in the pericardium, pleura, and peritoneum [9,10]; the FEEL is used in patients with cardiac arrest for no more than 10 seconds during the pulse check to search for reversible causes of cardiac arrest [11]; the RUSH goes rapidly through all the possible causes of shock [13].…”

“…Many out-of-hospital algorithms have been successfully tested by providers [9], including the focused assessment of sonography for trauma (FAST) and the Extended-FAST [9,10], the focused echocardiography in life support (FEEL) protocol during cardiopulmonary resuscitation (CPR) [11], the lung ultrasound (LUS) for the evaluation of respiratory insufficiency [2,12] and the rapid ultrasound for shock and hypotension (RUSH) protocol for hemodynamic instability [13]. The study of the abdominal aorta in a patient with abdominal pain and hemodynamic instability could be another important indication of pre-hospital US [2,14].…”

Dynamic thermal/acoustic response for human bone materials at different energy levels: A diagnosis approach

“…[1][2][3][4][5][6][7] These enable medical diagnosis with minimum risks, accurate results, and most importantly patient comfort. In some cases, non-invasive approaches are necessary with ''undesirable alternatives'' for critical surgeries.…”

Modern sonology and the bedside practitioner: evolution of ultrasound from curious novelty to essential clinical tool

“…For example, sonologists and proceduralists can claim substantial contributions in the areas of central [13] and peripheral [14] venous access, disaster triage [15], musculo-skeletal diagnosis and treatment [16,17], vascular diagnosis [18], intravascular volume status assessment [19], cardiovascular assessment [20,21], tracheal airway placement verification [2], ophthalmologic and neurologic applications [22][23][24][25], diagnosis of cholecystitis [26,27], appendicitis [28], and abdominal solid organ abnormalities [29][30][31][32], obstetric and gynecologic applications [33,34], and percutaneous drainage of fluid collections [35,36], among many other clinical uses [37][38][39][40][41].…”