title: [Introduction of Prehospital Emergency Ultrasound into an Emergency Medical Service Area].
abstract: BACKGROUND
  Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients.
  
  
  METHODS
  All emergency physicians at a rural emergency physician base were trained in emergency ultrasound scanning techniques (FAST, FEEL, 14 h of instruction), followed by regular weekly training sessions of approximately 30 min. Over a period of 12 months, prehospital ultrasound examinations performed during emergency physician callouts at this base were documented and analysed.
  
  
  RESULTS
  A total of 87 emergency ultrasound examinations were performed during 1343 callouts. Among these, focussed assessment with sonography for trauma (FAST) was performed in 35 patients (40.2%) and focused echocardiography in emergency life support (FEEL) in 41 patients (47.1%). In 11 patients (12.6%), ultrasound scans were performed for other indications (e. g. to rule out urinary tract obstruction in a case of flank pain). One trauma patient's life was saved by the decision to transport him to the nearest hospital and once there directly to the operating room, based on the ultrasound finding of significant free intra-abdominal fluid (ruptured spleen and liver).
  
  
  CONCLUSIONS
  Prehospital emergency ultrasound can be introduced into an emergency medical service area as a diagnostic modality that provides benefits to patients. Emergency physicians have to be specifically trained and to participate in continuous education activities. Especially in rural areas with longer transport routes and journey times, the early diagnosis of for example massive intra-abdominal bleeding is critical for the patient's prognosis.
authors.affiliation: Abteilung für Anästhesiologie, Intensivmedizin, Rettungsmedizin und Schmerztherapie, St.-Josefs-Hospital Cloppenburg, Krankenhausstraße 13, 49661, Cloppenburg, Deutschland. christian.weilbach@kk-om.de.
authors.forename: C
authors.initials: C
authors.lastname: Weilbach
authors.affiliation: Abteilung für Anästhesiologie, Intensivmedizin, Rettungsmedizin und Schmerztherapie, St.-Josefs-Hospital Cloppenburg, Krankenhausstraße 13, 49661, Cloppenburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Kobiella
authors.affiliation: Klinik für Anästhesiologie und operative Intensivmedizin, Franziskus-Hospital Bielefeld, Kiskerstraße 26, 33615, Bielefeld, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Rahe-Meyer
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Johanning
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000628:therapy; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004452:Echocardiography; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005858:Germany; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008021:Life Support Systems; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012424:Rural Population; D014463:Ultrasonography / Q000379:methods*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging
keywords: Abdominal trauma; Emergency ultrasound; Hypotonia; Preclinical examination; Prehospital emergency ultrasound