Using Ultrasound on the ambulance - Yes No Maybe?

[spenac]

So should we be doing utrasound in the ambulance? Does your service do it?

Why am I asking? http://www.911sono.com/ems_ultrasound_homepage.htm

[web:ddd1236e4a]http://www.911sono.com/ems_ultrasound_homepage.htm[/web:ddd1236e4a]

[ERDoc]

I almost used prehospital US use as my residency research project. I think there is some utility in it. I think the most useful purpose will be for FAST exams on trauma pts. It is nonivasive and pretty easy to use. Personally, I feel it would be a helpful tool in your toolbox.

[chbare]

A neat idea; however, will this change the way practice? What real benefits exist with this technology in the field. My employee is looking at fielding one of these devices in one of our aircraft. The data obtained will help our clinical bubbas decide if it is worth taking the plunge.

I know Austin has a progressive Medevac service using US. In addition to diagnostics, US is used to guide some procedures in the field such as IV placement.

Currently, I am not sure many services will have real use for such a device. Sure, it would be cool to do a FAST and ID an injury; however, will this really change the way we treat patients?

Take care,

chbare.

[VentMedic]

Money? (Expensive piece of equipment for IVs)

Durability?

Time on scene?

Transport time?

Training?

Competency?

More training?

Frequency of use? (Doctors may use them in the ED regularly to keep their skills.)

Retraining?

QA/QC?

Intervention capabilities?

Is the service able to do chest tubes and not just needle decompression?

What meds do you carry? Blood products?

What OB interventions? Yes, OB specialty teams may or may not use them. Usually they know their limitations in transport but also have more knowledge and skills in their "tool bag". They may also have more time at the sending hospital in a controlled environment to obtain a quality US scan.

Flight medicine is different but that also depends on total transport time and the abilities of the crew.

[Mateo_1387]

Just from my limited knowledge of US technology I have some things that I think may need to be looked at, and some idea of how it may help in EMS with treatment.

The issues that may need to be considered (at least in my own head).

Will it delay scene time for trauma patients?

How easy is it to read an US in the back of a moving ambulance?

Is using an US one of those skills you need to do often to be proficient at?

As far as treatment goes?

I would think that US may help treatment plans by giving the medic a better idea of what is going on. Early recognition of problem could lead to shorter hospital times for patients, as well as faster treatment for life threatening emergencies.

I am thinking it may help with:

OB patients- finding position, size of, twins, placenta previa

Vascular access- Placement of central lines

Trauma Patients- Internal bleeding

These are just some ideas, and again I asked the questions based on very limited knowledge about US technology.

[VentMedic]

I pulled up another interesting article on this from Odessa FD.

http://www.odessa-tx.gov/public/firedepart...calGov2008w.pdf

The "golden hour" was stressed again.

In the medical field a “Golden Hour” is used when a trauma patient receives advanced and definitive care

within an hour’s time.

Initially when this idea came about the ER physicians were skeptical on paramedics in the field having the knowledge and ability to perform the procedure. Dr. Spear developed a training program and aids to implement the use of the sonogram machine. Making the use of ultrasound as simple to understand as possible was a goal of the paramedic training program. For example, during the training phase Dr. Spear explained the view of the ultrasound probe, similar to a “slice of a watermelon” and to the view the body as such.

Sidney Sinus node anyone?

No science required.

This got a chuckle out of our Registered Ultrasound Technologists.

[spenac]

Sidney Sinus node anyone?

This got a chuckle out of our Registered Ultrasound Technologists.

You know there is nothing wrong with getting a simple explanation of something so it makes sense. Why in the hell does everyone jump on Nancy Caroline for using plain English to help make a a point clear and easy to understand ( Your Sidney Sinus statement )? I get sick of people always acting like they read only the book with big words and never had anyone break something down to its basic simple meaning. I have seen the MD section at the book store, and yes they have some big books with words to big to fit on my belt but there are also simple plain english books there to that help them understand the big books. And God forbid I offend your Registered Ultrasound Technologists that I am positive never took and had to have someone or something explain something in simple poor folk talk how it really works. :roll:

I agree more education is needed but come off the BS.

As to the ultrasound. Why not use it? Perhaps it really would not change what we do as far as patient care most times, but it might allow us pre-hospital Healthcare Professionals ( or as edumacated folk call us simple folk, ambulance drivers) to give all the hospital Gods a heads up.

And no I am no part of Odessa FD and their outdated in most cases protocols.

[Eydawn]

I'm actually writing an argumentative paper on effective healthcare practitioner/patient communication. Specifically for those brand new docs out there... who don't know how to explain things without using the foreign language that is medical-speak.

But I would expect the technologists to laugh at it... kind of like how we laugh at the "asthma is breathing through a McDonald's straw" lesson...

I just hope they'd be able to suppress the laughter long enough to explain it to a patient or family member with much lower education levels.

Wendy

CO EMT-B

[AZCEP]

Cost and utility would be my major concerns with adding US to the prehospital arena. If the physicians aren't willing to take our word on ECGs, how likely are they to listen to our interpretation of an US? I suppose it could be useful to add to triage decisions, but there are many questions to be answered first.

[spenac]

I'm actually writing an argumentative paper on effective healthcare practitioner/patient communication. Specifically for those brand new docs out there... who don't know how to explain things without using the foreign language that is medical-speak.

But I would expect the technologists to laugh at it... kind of like how we laugh at the "asthma is breathing through a McDonald's straw" lesson...

I just hope they'd be able to suppress the laughter long enough to explain it to a patient or family member with much lower education levels.

Wendy

CO EMT-B

But that would not be allowed. It is just to simple for educated people. :roll:

Actually I have found most Doctors have no problem admitting that they did at times need help understanding the big book with big words. It really seems to be the ones between them and us Pre-Hospital Healthcare Professionals that seem to think that by getting a clear picture it proves you are ignorant thus should not be done, it would just be better to act like you understand than ask for the simple explanation.