title: Paramedic application of ultrasound in the management of patients in the prehospital setting: a review of the literature.
abstract: OBJECTIVE
  Recently, attempts have been made to identify the utility of ultrasound in the management of patients in the prehospital setting. However, in the UK there is no directly relevant supporting evidence that prehospital ultrasound may reduce patient mortality and morbidity. The evidence available to inform this debate is almost entirely obtained from outside the UK, where emergency medical services (EMS) routinely use doctors as part of their model of service delivery. Using a structured review of the literature available, this paper examines the evidence to determine 'Is there a place for paramedic ultrasound in the management of patients in the prehospital setting?'
  
  
  METHODS
  A structured review of the literature to identify clinical trials which examined the use of ultrasound by non-physicians in the prehospital setting.
  
  
  RESULTS
  Four resources were identified with sufficient methodological rigour to accurately inform the research question.
  
  
  CONCLUSIONS
  The theoretical concept that paramedic-initiated prehospital ultrasound may be of benefit in the management of critically ill patients is not without logical conceptual reason. Studies to date have demonstrated that with the right education and mentorship, some paramedic groups are able to obtain ultrasound images of sufficient quality to positively identify catastrophic pathologies found in critically ill patients. More research is required to demonstrate that these findings are transferable to the infrastructure of the UK EMS, and in what capacity they may be used to help facilitate optimal patient outcomes.
authors.affiliation: North West Ambulance Service NHS Trust, c/o Broughton House, 449-451 Garstang Road, Broughton, Nr Preston PR3 5LN. michael.brooke@nwas.nhs.uk
authors.forename: Mike
authors.initials: M
authors.lastname: Brooke
authors.forename: Julie
authors.initials: J
authors.lastname: Walton
authors.forename: Diane
authors.initials: D
authors.lastname: Scutt
mesh_terms: D000488:Allied Health Personnel; D002986:Clinical Trials as Topic; D004632:Emergency Medical Services; D006801:Humans; D014463:Ultrasonography / Q000706:statistics & numerical data*; D006113:United Kingdom