Handheld Ultrasound

[Arctickat]

Anyone out here using handheld ultrasound in their vehicles? If so, what was the learning curve like? Do you use it for finding gross anomalies that would result in changes to your destination facility? Do you use it for less acute situations, such as fetal monitoring?

I'm thinking of getting one to try out on one of my ambulances, but I want it to have purpose rather than be a toy.

[Just Plain Ruff]

good thoughts but you just know it will be mis-used by your not so honest medics and emt's. But that aside

I've used on in the ED but never on the ambulance. I think that the broad reasons for having this would be apparant, fetal monitoring would be the most used I think.

the learning curve wasn't steep, but you have to have a good trainer.

I think it would be just one more (expensive) tool in your arsenal of tools.

Interesting to see where it goes from here for you, I'd be interested to see what it was actually used for. Just have a pretty rigid set of guidelines set up to use it, and I would only allow it used by one or two medics for the roll out.

[paramedicmike]

I've never used one prehospitally. I remember reading something about Houston, TX (if I recall correctly) EMS field testing portable US devices. There were a couple articles floating around out there in some of the trade magazines (Jems and the like).

[scubanurse]

I almost feel like a doppler would be more beneficial in the field. It could be used for fetal monitoring and for pulses in a trauma or code situation. U/S seems like too specific of a skill to be beneficial in the field and leaves a lot up to misinterpretation that could affect outcomes.

[medicmole]

Kat

STARS uses them, you could call and see what they think.

[Arctickat]

Sorry Ruff....I'm a bit naive here...misused in what manner? My organisation is small enough that it would only be used by me and one or two others. Thanks for the info Medic, I wasn't aware that STARS was using them. My plan is to be able to transmit the feed to the trauma centre.

[Just Plain Ruff]

Sorry Ruff....I'm a bit naive here...misused in what manner? My organisation is small enough that it would only be used by me and one or two others. Thanks for the info Medic, I wasn't aware that STARS was using them. My plan is to be able to transmit the feed to the trauma centre.

well, I would think that some of the mis-use would be from certain medics, NOT saying you have them, but doing ultrasounds on themselves. Or someone doing ultrasounds on family members or friends to show them the cool new toy. That's the mis-use I was referring to.

Refer back when Nitrox was just being implemented in some services. I know direct knowledge of some crews using the nitrous on them selves.

There is a well spread rumor in KC MO that one of the ambulance wrecks that caused thousands and thousands of dollars damage was caused by one EMT who was abusing nitrous and driving. It was not a good thing.

Edited April 29, 2015 by Ruffmeister Paramedic

[paramedicmike]

There's a little bit of a difference between abusing the nitrous and using an onboard US.

[Just Plain Ruff]

There's a little bit of a difference between abusing the nitrous and using an onboard US.

of course there is Mike, I was just saying that this tool could be mis-used just like any other tool and there should be guidelines as to how to use it.

for example - using the ultrasound on a friend to show them what their baby looks like and an anomoly is found - that's mis-use. Using it to look at an area of pain for a friend and finding some sort of abnormality, that's mis-use because you are not using in a actual patient care activity.

One example personally - we had these new IV catheters that were supposed to be placed in patients for long term IV use. We had not been trained and they were only to be used by those trained by the IV team. One night we were bored (if alcohol was involved we would have said "here hold my beer") and we practiced on another medic in the ED. We placed the IV cath correctly but did not pull the needle out and leave the catheter for advancement. Placed the IV cath in the AC space, advanced it and the medic said he felt a pop in the biceps area and the next thing we know his arm is swelling up like a baloon because we damaged the vein. No long term effects other thana really sore arm. That's similar to the mis-use I'm talking about.

make more sense?

[MCSOU]

I truly believe ultrasound is more beneficial than 12 lead technology for EMS (not saying we should take it away by any means here). If you do your homework and practice a handheld ultrasound can provide a FAST exam within 30 seconds, tell you in minutes why your patient is in shock, assist with IV placement, do cardiac, vessel, and fetal assessments.