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INTRODUCTION

Prehospital ultrasound allows caregivers to dramatically increase the amount of diagnostic information gathered as well as reduce the time to diagnosis. Information obtained can be used to mobilize appropriate definitive care resources as well as accelerate and improve accuracy of interventions. Ambient noise, vibration, and other factors not encountered in the hospital can impede usual patient assessment techniques in the prehospital environment. Many of these limitations can be addressed by the use of ultrasound.

CURRENT STATE OF PREHOSPITAL ULTRASOUND

Since the early 2000s, prehospital ultrasound has rapidly progressed from initial case reports1,2 to feasibility studies, and more recently to describing effect on outcomes in trauma and medical patients in meta-analysis, confirming the rapid maturation of its application.3,4 Several recent studies have concluded that use of prehospital ultrasound results in significant changes in patient management (Table 28-1).

TABLE 28-1.STUDIES EXAMINING THE IMPACT OF PREHOSPITAL ULTRASOUND ON PATIENT CARE5–7

The United States

Initial description of ultrasound use on aeromedical units in the early 2000s was followed in 2010 by ground-based advanced life support ambulance demonstration projects.1,2 In the subsequent decade there has been rapid adoption of ultrasound in the prehospital environment, particularly by rotor-wing critical care units. Though the indications for use vary, most published applications address the use of the focused assessment with sonography for trauma (FAST) examination. These ultrasound examinations are goal-directed (limited windows, binary interpretation of results) to accommodate the training level of the providers and simplify interpretation as real-time interpretation and oversight can ...

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