Prehospital ultrasound by paramedics: results of field trial.
OBJECTIVE
The objective was to determine if 9-1-1 paramedics trained in ultrasound (US) could adequately perform and interpret the Focused Assessment Sonography in Trauma (FAST) and the abdominal aortic (AA) exams in the prehospital care environment.


METHODS
Paramedics at two emergency medical services (EMS) agencies received a 6-hour training program in US with ongoing refresher education. Paramedics collected US in the field using a prospective convenience methodology. All US were performed in the ambulance without scene delay. US exams were reviewed in a blinded fashion by an emergency sonographer physician overreader (PO).


RESULTS
A total of 104 patients had an US performed between January 1, 2008, and January 1, 2009. Twenty AA exams were performed and all were interpreted as negative by the paramedics and the PO. Paramedics were unable to obtain adequate images in 7.7% (8/104) of the patients. Eighty-four patients had the FAST exam performed. Six exams (6/84, 7.1%) were read as positive for free intraperitoneal/pericardial fluid by both the paramedics and the PO. FAST and AA US exam interpretation by the paramedics had a 100% proportion of agreement with the PO.


CONCLUSIONS
This pilot study shows that with close supervision, paramedics can adequately obtain and interpret prehospital FAST and AA US images under protocol. These results support a growing body of literature that indicates US may be feasible and useful in the prehospital setting.
Heegaard
William
W
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA. william.heegaard@hcmed.org
Hildebrandt
David
D
Spear
David
D
Chason
Kevin
K
Nelson
Bret
B
Ho
Jeffrey
J
D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D004632:Emergency Medical Services / Q000592:standards; D004634:Emergency Medical Technicians / Q000193:education; D006801:Humans; D008910:Minnesota; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods / Q000592:standards; D055815:Young Adult