paramedic ultrasound

OBJECTIVE: The primary goal of this study was to determine if ultrasound (US) use after brief point-of-care ultrasound (POCUS) training on cardiac and lung exams would result in more paramedics correctly identifying a tension pneumothorax (TPTX) during a simulation scenario. METHODS: A randomized controlled, simulation-based trial of POCUS lung exam education investigating the ability of paramedics to correctly diagnose TPTX was performed. The US intervention group received a 30-minute cardiac and lung POCUS lecture followed by hands-on US training...

INTRODUCTION: Prehospital use of lung ultrasound (LUS) by paramedics to guide the diagnoses and treatment of patients has expanded over the past several years. However, almost all of this education has occurred in a classroom or hospital setting. No published prehospital use of LUS simulation software within an ambulance currently exists. STUDY OBJECTIVE: The objective of this study was to determine if various ambulance driving conditions (stationary, constant acceleration, serpentine, and start-stop) would impact paramedics' abilities to perform LUS on a standardized patient (SP) using breath-holding to simulate lung pathology, or to perform LUS using ultrasound (US) simulation software...

BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) exam is a rapid ultrasound test to identify evidence of hemorrhage within the abdomen. Few studies examine the accuracy of paramedic performed FAST examinations. The duration of an ultrasound training program remains controversial. This study's purpose was to assess the accuracy of paramedic FAST exam interpretation following a one hour didactic training session. METHODS: The interpretation of paramedic performed FAST exams was compared to the interpretation of physician performed FAST examinations on a mannequin model containing 300ml of free fluid following a one hour didactic training course...

BACKGROUND: Point of care ultrasound (POCUS) is an essential tool for physicians to guide treatment decisions in both hospital and prehospital settings. Despite the potential patient care and system utilization benefits of prehospital ultrasound, the financial burden of a "hands-on" training program for large numbers of paramedics remains a barrier to implementation. In this study, we conducted a prospective, observational, double-blinded study comparing paramedics to emergency physicians in their ability to generate usable abdominal ultrasound images after a 1-hour didactic training session...

INTRODUCTION: The Advanced Cardiac Life Support (ACLS) guidelines were recently updated to include ultrasound confirmation of endotracheal tube (ETT) location as an adjunctive tool to verify placement. While this method is employed in the emergency department under the guidance of the most recent American College of Emergency Physicians (ACEP; Irving, Texas USA) guidelines, it has yet to gain wide acceptance in the prehospital setting where it has the potential for greater impact. The objective of this study to is determine if training critical care medics using simulation was a feasible and reliable method to learn this skill...

OBJECTIVES: The purpose of this study was to evaluate the performance of a handheld ultrasound device for difficult peripheral intravenous (PIV) access performed by nurses and paramedics in the emergency department (ED). METHODS: This was a retrospective review at an academic medical center. Participants were ED nurses and paramedics with competence in ultrasound-guided PIV placement. Participants were asked to log their use of the handheld device when used on patients deemed to have "difficult" access and complete a questionnaire, which consisted of items related to the effectiveness and ease of use of the device...

BACKGROUND: There has been an explosive growth of ECPR within new and established ECMO programs worldwide with the concomitant need for simulation trainers. However, current commercially available ECMO simulation models are expensive and lack many standard cardiorespiratory resuscitative (CPR) features. OBJECTIVE: To use 3-dimensional (3D) printing to develop a training manikin for comprehensive ECPR simulation. METHODS: A standard commercially available CPR manikin with airway model was used as the base model for modification...

OBJECTIVE: Point-of-care ultrasound is a nascent and growing area of prehospital care. Most previously described ultrasound curricula for paramedics examine a single type of ultrasound scan. Here, we describe the implementation and evaluation of a prehospital ultrasound curriculum using a blended model of traditional didactics and hands-on experience with online prereading. METHODS: We recruited a prospective convenience sample of critical care paramedics without prior ultrasound experience to take part in a 2-day ultrasound course...

OBJECTIVES: Rapid identification of esophageal intubations is critical to avoid patient morbidity and mortality. Continuous waveform capnography remains the gold standard for endotracheal tube (ETT) confirmation, but it has limitations. Point-of-care ultrasound (POCUS) may be a useful alternative for confirming ETT placement. The objective of this study was to determine the accuracy of paramedic-performed POCUS identification of esophageal intubations with and without ETT manipulation...

Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...

OBJECTIVE: Prehospital ultrasound is not yet widely implemented. Most studies report on convenience samples and trauma patients, often by prehospital physicians or critical care clinicians. We assessed the feasibility of paramedic performed prehospital lung ultrasound in medical patients with respiratory distress. METHODS: Paramedics at 2 ambulance stations in the city of Pittsburgh, Pennsylvania, USA underwent a 2-hour training session in prehospital lung ultrasound using the SonoSite iViz, a handheld ultrasound device...

BACKGROUND: Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information that can assist with management and guide transport to the most appropriate facility. We sought to explore the different educational approaches used for training paramedics in ultrasound in the out-of-hospital setting. METHODS: Ovid MEDLINE, EMBASE, EBM Reviews, The Cochrane Library, CINAHL plus, The Monash University Research Repository and the British Thesis Library were searched from the 1st of January 1990 to the 6th of April 2016...

CONTEXT: Hypoglycemia is a rare event in healthy adults, and the differential diagnosis includes many diseases, some of which are rare and easily missed. DESIGN, SETTING, DESCRIPTION: A 20-year-old male military paramedic was referred to our emergency department for investigation of recurrent hypoglycemia episodes during the previous months. Factitious hypoglycemia was excluded, and organic hyperinsulinemic hypoglycemia was diagnosed by the findings from a prolonged fast...

OBJECTIVES: Can pre-hospital paramedic responders perform satisfactory pre-hospital Echo in Life Support (ELS) during the 10-s pulse check window, and does pre-hospital ELS adversely affect the delivery of cardiac arrest care. METHODS: Prospective observational study of a cohort of ELS trained paramedics using saved ultrasound clips and wearable camera videos. RESULTS: Between 23rd June 2014 and 31st January 2016, seven Resuscitation Rapid Response Unit (3RU) paramedics attended 45 patients in Lothian suffering out-of-hospital CA where resuscitation was attempted and ELS was available and performed...

BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation...

INTRODUCTION: It is unclear how many ultrasound-guided peripheral intravenous catheters (USG PIVC) one must place to become proficient at the procedure. The objective of this study was to determine the learning curve associated with PIVC placement and determine how many attempts are required for non-physician learners to reach proficiency. METHODS: This is a prospective observational study. Emergency department (ED) nurses and paramedics with competence in traditional PIVC placement underwent a USG PIVC placement training program...

OBJECTIVE: Prehospital ultrasound is being applied in the field. The purpose of this systematic review is to describe evidence pertaining to ultrasound curricula for paramedics specifically, including content, duration, setting, design, evaluation, and application. METHODS: Electronic searches of MEDLINE, Embase, CINAHL, and the Cochrane Center Register of Controlled Trials were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...

BACKGROUND: A robotic arm was developed by our laboratory for tele-operated echography on patients in locations isolated from a trained sonographer. The objective of the study was to evaluate, over a 1-year period, the use of the robotic arm for telesonography performed by a sonographer located at the University Hospital (Tours, France) on patients in two isolated medical centers 50 km away linked via the Internet. MATERIALS AND METHODS: A nonsonographer operator (physician or paramedic) located the ultrasound probe attached to the robotic arm over the appropriate acoustic window for the organ of interest by rolling the whole robotic arm and mechanical support across the floor...

INTRODUCTION: In the United States, there are limited studies regarding use of prehospital ultrasound (US) by emergency medical service (EMS) providers. Field diagnosis of life-threatening conditions using US could be of great utility. This study assesses the ability of EMS providers and students to accurately interpret heart and lung US images. METHODS: We tested certified emergency medical technicians (EMT-B) and paramedics (EMT-P) as well as EMT-B and EMT-P students enrolled in prehospital training programs within two California counties...

OBJECTIVES: The aim of this study was to determine whether paramedics can be trained to perform and interpret focussed Echo in Life Support (ELS) for the assessment of cardiac movement and the recognition of reversible causes of cardiac arrest. METHODS: This study is a prospective observational pilot study. Data were collected during a 1-day course training 11 paramedics to perform ELS scans on healthy volunteers. The students were assessed on image acquisition skills and theoretical knowledge (including interpretation)...