Tele-ultrasound
and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma
examination.
Am J Emerg Med. 2010 Apr 12. [Epub ahead of
print]�� Boniface KS, Shokoohi H,
Smith ER, Scantlebury K.
Department of Emergency Medicine, George Washington
University Medical Center, Washington, DC 20037, USA.
Abstract
OBJECTIVES:
The aim of this
study was to examine the capability of ultrasound-na�ve paramedics to obtain
interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote
direction of emergency physicians (EPs).
METHODS:
Paramedics
without experience using ultrasound participated in a 20-minute lecture
covering orientation to the ultrasound machine and the FAST examination. The
paramedics subsequently performed FAST examinations on a model patient, whereas
the EP remained in another room, out of visual contact. The EP communicated
with the paramedic via radio, viewing video from the ultrasound machine on a
monitor and directing the probe movements to obtain the views of the FAST
examination. We examined the success rate, time to complete the examinations,
and adequacy of images from the paramedics' first FAST examination.
RESULTS:
Fifty-one
paramedics performed their first FAST examinations and were able to
successfully complete 100% of the views of the FAST. The median time from probe
placement to examination completion was 262 seconds (interquartile
range, 206-343 seconds). The median time to complete right upper quadrant (RUQ)
versus left upper quadrant (LUQ) views was 39 and 50 seconds, respectively. The
time to complete the LUQ scan took significantly longer than the RUQ (P <
.01). Paramedics completed cardiac and pelvic view in a median time of 42 and
25 seconds, respectively.
CONCLUSIONS:
The study
demonstrated that paramedics with no prior ultrasound experience could obtain
FAST images under remote guidance from experienced EPs in less than 5 minutes.
Given rapidly evolving data transmission technology, this has applicability in
battlefield, remote, and rural prehospital settings.
Copyright � 2010 Elsevier Inc. All rights reserved.
PMID:
20825815 [PubMed - as supplied by publisher]