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paramedic ultrasound

Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
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...
January 1, 2017: Journal of Telemedicine and Telecare
Torben K Becker, Christian Martin-Gill, Clifton W Callaway, Francis X Guyette, Christopher Schott
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...
March 2018: Prehospital Emergency Care
Ben Meadley, Alexander Olaussen, Ashleigh Delorenzo, Nick Roder, Caroline Martin, Toby St Clair, Andrew Burns, Emma Stam, Brett Williams
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 1(st) of January 1990 to the 6(th) of April 2016...
June 17, 2017: BMC Emergency Medicine
Amichai Gutgold, David J Gross, Benjamin Glaser, Auryan Szalat
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...
February 1, 2017: Journal of Clinical Endocrinology and Metabolism
Matthew J Reed, Louise Gibson, Alistair Dewar, Steven Short, Polly Black, Gareth R Clegg
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...
March 2017: Resuscitation
Kevin P Rooney, Sari Lahham, Shadi Lahham, Craig L Anderson, Bryan Bledsoe, Bryan Sloane, Linda Joseph, Megan B Osborn, John C Fox
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...
2016: World Journal of Emergency Medicine
Lori A Stolz, Anthony R Cappa, Michael R Minckler, Uwe Stolz, Ryan G Wyatt, Carl W Binger, Richard Amini, Srikar Adhikari
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...
July 12, 2016: Journal of Vascular Access
Jessica McCallum, Erik Vu, David Sweet, Hussein D Kanji
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...
November 2015: Air Medical Journal
Monica Georgescu, Arnaud Sacccomandi, Bernard Baudron, Philippe L Arbeille
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...
April 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Sundeep R Bhat, David A Johnson, Jessica E Pierog, Brita E Zaia, Sarah R Williams, Laleh Gharahbaghian
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...
July 2015: Western Journal of Emergency Medicine
Katherine L Booth, Matthew J Reed, Shirin Brady, Kristina R Cranfield, Ravin Kishen, Katy Letham, Graeme McAlpine, Douglas B Murray, Emma-Beth Wilson, Mike Wilson, Steven Short, Gareth R Clegg
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)...
December 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Brian West, Andrew Cusser, Stuart Etengoff, Hank Landsgaard, Virginia LaBond
INTRODUCTION: The Focused Abdominal Sonography in Trauma (FAST) scan is used to detect free fluid in the peritoneal cavity, or pericardium, to quickly assess for injuries needing immediate surgical intervention. Mass-casualty incidents (MCIs) are settings where paramedics must make triage decisions in minutes. The Simple Triage and Rapid Transport (START) system is used to prioritize transport. The FAST scan can be added to the triage of critical patients, and may aid in triage. METHODS: This was a single-blinded, randomized control trial...
December 2014: Prehospital and Disaster Medicine
I Kassegne, K Kanassoua, E V Sewa, B Tchangaï, J Sambiani, A E Ayité, E D Dosseh
PURPOSE: The aim of this study was to describe the epidemiologic, diagnostic, and therapeutic aspects of surgical abdominal emergencies in a teaching hospital in a developing country (Togo). MATERIAL AND METHOD: This retrospective study included the medical files of all patients managed for surgical abdominal emergencies from March 1, 2002, to March 1, 2012. RESULTS: The study included 594 patients, with a mean age of 30.3 years (range: 1 month to 80 years) and a 2...
January 2015: Médecine et Santé Tropicales
Laetitia Yperzeele, Robbert-Jan Van Hooff, Ann De Smedt, Alexis Valenzuela Espinoza, Rohny Van de Casseye, Ives Hubloue, Jacques De Keyser, Raf Brouns
BACKGROUND: The global burden of stroke is immense, both in medical and economic terms. With the aging population and the ongoing industrialization of the third world, stroke prevalence is expected to increase and will have a major effect on national health expenditures. Currently, the medical treatment for acute ischemic stroke is limited to intravenous recombinant tissue plasminogen activator (IV r-tPA), but its time dependency leads to low utilization rates in routine clinical practice...
2014: Cerebrovascular Diseases
Alison Sparke, Karina Torlei, Sarah Voss, Mike Page, Jonathan Benger, Ed Matthews, Michael Hillman, Darren Hart, Ella McLaughlin, Jane Carter, Nigel Harris
INTRODUCTION: The early application of a semirigid disposable cervical collar following trauma is considered a routine practice. The aim of these devices is to immobilise the cervical spine and minimise the risk of additional neurological damage. However, these collars provide only partial immobilisation, are uncomfortable and are associated with a number of complications. Our team designed and tested a novel cervical immobilisation device that aims to improve immobilisation with reduced complications: the 'Necksafe'...
July 2015: Emergency Medicine Journal: EMJ
Moriz Herzberg, Sandra Boy, Thilo Hölscher, Michael Ertl, Markus Zimmermann, Karl-Peter Ittner, Josef Pemmerl, Hendrik Pels, Ulrich Bogdahn, Felix Schlachetzki
BACKGROUND: Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular emergency diagnostics when performed in a prehospital setting using mobile ultrasound equipment as part of a neurological examination. METHODS: Following a '911 stroke code' call, stroke neurologists experienced in TCCS rendezvoused with the paramedic team...
February 27, 2014: Critical Ultrasound Journal
Nancy Biegler, Paul B McBeth, Martha C Tevez-Molina, Janelle McMillan, Innes Crawford, Douglas R Hamilton, Andrew W Kirkpatrick
PURPOSE: Remote telementored ultrasound (RTMUS) is a new discipline that allows a remote expert to guide variably experienced clinical responders through focused ultrasound examinations. We used the examination of the pleural spaces after tube thoracostomy (TT) removal by a nurse with no prior ultrasound experience as an illustrative but highly accurate example of the technique using a simple cost-effective system. MATERIALS AND METHODS: The image outputs of a handheld ultrasound machine and a head-mounted Web camera were input into a customized graphical user interface and streamed over a freely available voice over Internet protocol system that allowed two-way audio and visual communication between the novice examiner and the remote expert...
December 2012: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
N O'Mahony, E McCarthy, R McDermott, S O'Keeffe
OBJECTIVE: The aim of this study was to explore patients' perceptions of the role of the radiologist in their care. METHODS: The questionnaire used was designed in conjunction with a psychologist who had an interest in oncology, and piloted. The final questionnaires were distributed to patients attending the breast clinic at St James's Hospital, Dublin, Ireland, from 1 March to 1 July 2011. Patients requiring imaging (mammography and/or ultrasound) were asked to complete the same questionnaire again after imaging procedures were performed...
December 2012: British Journal of Radiology
Bryan Bledsoe, Pat Songer, Kelly Buchanan, Jeff Westin, Ryan Hodnick, Loren Gorosh
INTRODUCTION: Burning Man is a large weeklong outdoor arts festival held annually in the rugged and austere Black Rock Desert in northern Nevada. The 2011 event presented several unusual challenges in terms of emergency medical services (EMS) and medical care provision. OBJECTIVE: This paper details the planning and subsequent emergency medical care for Burning Man 2011. METHODS: This was a retrospective, observational review of the preparation, management, and medical care at Burning Man 2011...
October 2012: Prehospital Emergency Care
Eric J Chin, Connie H Chan, Rod Mortazavi, Craig L Anderson, Christopher A Kahn, Shane Summers, J Christian Fox
BACKGROUND: Prehospital ultrasound has been shown to aid in the diagnosis of multiple conditions that do not generally change prehospital management. On the other hand, the diagnoses of cardiac tamponade, tension pneumothorax, or cardiac standstill may directly impact patient resuscitation in the field. STUDY OBJECTIVE: To determine if prehospital care providers can learn to acquire and recognize ultrasound images for several life-threatening conditions using the Prehospital Assessment with UltraSound for Emergencies (PAUSE) protocol...
January 2013: Journal of Emergency Medicine
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