Live Stream of Ultrasound in Prehospital Medical Care

Live Stream of Emergency Ultrasound to Improve Diagnostics in Prehospital Medical Care: a Feasibility Study

Prehospital emergency ultrasound (PEU) is being increasingly used in different preclinical emergency systems across the world. Ultrasound examinations in emergency situations, however, remain challenging even in the hospital setting despite the availability of standardized approaches such as Focused Assessment with Sonography for Trauma (FAST). Preclinical circumstances further complicate the adequate execution of an additional diagnostic tool such as PEU on the scene or inside a medical emergency vehicle. Furthermore, rapid translation of ultrasound findings into meaningful therapeutic consequences is considerably demanding in an environment of limited resources. If focused PEU is correctly used and patients' condition allows emergency doctors a careful ultrasound examination, it is possible to differentiate life-threatening diagnoses. PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems. To date it is unclear whether PEU results in improved outcome.

Some emergency cases present difficult challenges in the prehospital ultrasound examination. Portable devices designed for PEU suggest the possibility of increasing the use of ultrasound "in the field". However, to the investigator's knowledge, opportunities for real-time consultation with a second specialist including live transmission of the ultrasound picture are not being provided at any preclinical emergency facility.

Study Overview

• Status: Completed
• Conditions: Ultrasound
• Intervention / Treatment: Other: Prehospital ultrasound

Detailed Description

Aim 1:

Feasibility of real time prehospital emergency ultrasound (PEU) transmission in a university affiliated preclinical emergency system.

Aim 2:

Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.

Hypothesis:

We expect that live streaming of emergency ultrasound images in order to allow a second opinion could improve diagnostics of life threatening conditions and help us to improve patients' safety by digital health. The use of PEU is feasible and safe.

• Study Type: Observational
• Enrollment (Actual): 25

Contacts and Locations

Study Locations

• Austria
  • Vienna, Austria, 1090
    • Medical University of Vienna - Division of General Anaesthesia and Intensive Care Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 116 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems.

Description

Inclusion Criteria:

Emergency patients affected by:

• trauma
• cardiac arrest/shock
• respiratory problems

Exclusion Criteria:

• Patients rejection.
• Legal representative's rejection.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of PEU live stream.	Numerical scale (1-10; 1 = best, 10 = poor)	3 Months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Expert available on time? Communication? Duration of ultrasound examination? Duration of live stream? Delay by PEU transmission? Emergency duration with/without PEU transmission Technical problems?	3 Months
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Communication?	3 Months
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Duration of ultrasound examination?	3 Months
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Duration of live stream?	3 Months
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Delay by PEU transmission?	3 Months
Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Emergency duration with/without PEU transmission technical problems?	3 Months

Collaborators and Investigators

• Sponsor: Medical University of Vienna

Publications and helpful links

General Publications

• Botker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma Resusc Emerg Med. 2018 Jun 26;26(1):51. doi: 10.1186/s13049-018-0518-x.
• van der Weide L, Popal Z, Terra M, Schwarte LA, Ket JCF, Kooij FO, Exadaktylos AK, Zuidema WP, Giannakopoulos GF. Prehospital ultrasound in the management of trauma patients: Systematic review of the literature. Injury. 2019 Dec;50(12):2167-2175. doi: 10.1016/j.injury.2019.09.034. Epub 2019 Sep 28.
• Scharonow M, Weilbach C. Prehospital point-of-care emergency ultrasound: a cohort study. Scand J Trauma Resusc Emerg Med. 2018 Jun 18;26(1):49. doi: 10.1186/s13049-018-0519-9.
• Ketelaars R, Reijnders G, van Geffen GJ, Scheffer GJ, Hoogerwerf N. ABCDE of prehospital ultrasonography: a narrative review. Crit Ultrasound J. 2018 Aug 8;10(1):17. doi: 10.1186/s13089-018-0099-y.
• Marsh-Feiley G, Eadie L, Wilson P. Telesonography in emergency medicine: A systematic review. PLoS One. 2018 May 3;13(5):e0194840. doi: 10.1371/journal.pone.0194840. eCollection 2018.
• Schmid M, Dodt C. [Emergency lung ultrasound]. Med Klin Intensivmed Notfmed. 2018 Nov;113(8):616-624. doi: 10.1007/s00063-018-0485-z. Epub 2018 Oct 10. German.
• Hermann M, Hafner C, Scharner V, Hribersek M, Maleczek M, Schmid A, Schaden E, Willschke H, Hamp T. Remote real-time supervision of prehospital point-of-care ultrasound: a feasibility study. Scand J Trauma Resusc Emerg Med. 2022 Mar 24;30(1):23. doi: 10.1186/s13049-021-00985-0.

Study record dates

Study Major Dates

• Study Start (Actual): October 19, 2020
• Primary Completion (Actual): August 31, 2021
• Study Completion (Actual): August 31, 2021

Study Registration Dates

• First Submitted: October 20, 2020
• First Submitted That Met QC Criteria: October 27, 2020
• First Posted (Actual): November 3, 2020

Study Record Updates

• Last Update Posted (Actual): September 14, 2021
• Last Update Submitted That Met QC Criteria: September 13, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: echocardiography; telemedicine; emergency medicine
• Other Study ID Numbers: Prehospital Ultrasound LBI/MUV

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No