Live Stream of Prehospital point-of Care Ultrasound by Air Rescue Physicians

Background: Point-of-care ultrasound (POCUS) has been suggested as a useful tool in emergency medicine for diagnosis and treatment of reversible causes. However, in prehospital setting performing ultrasound and the translation of the findings can be challenging. As new prehospital ultrasound devices offer the possibility for remote supervision, the impact of tele-supervision on time to diagnosis of critically ill patients is unclear.

Aims: The aim of this study is to evaluate the impact of tele-supervision on the time of POCUS in prehospital critically ill patients by air rescue physicians.

Methods: In total 100 critically ill patients suffering from acute dyspnoea, circulatory failure or trauma, which are treated by air rescue physicians will be included in this study. Duration of ultrasound performance as well as altered treatment strategies will be analyzed.

Study Overview

• Status: Withdrawn
• Conditions: Telemedicine; Echocardiography
• Intervention / Treatment: Other: Point-of-care ultrasound with tele-supervision; Other: Point-of-care ultrasound without tele-supervision

• Study Type: Observational

Contacts and Locations

Study Locations

• Austria
  • Vienna, Austria, 1090
    • Medical University of Vienna, Department of Anaesthesia & General Intensive Care

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

100 critically ill patients with acute dyspnoea, circulatory failure or trauma, will be included in this study. In 50 patients POCUS with tele-supervision and in 50 patients POCUS without tele-supervision will be performed. Tele-supervision is available in 50% of the time. Allocation to one of the two groups depends on the availability of tele-supervision.

Description

Inclusion Criteria:

Critically ill patients suffering from acute dyspnoea, circulatory failure or trauma will be included.

Patients with acute dyspnoea will be included, if they show at least one of the two following signs of respiratory failure:

• Respiratory rate > 20 breaths per minute
• Peripheral oxygen saturation without oxygen supplementation < 90%

Patients with acute circulatory failure will be included, if they show at least one of the following signs:

• Hypotension (systolic blood pressure <90mmHg)
• Altered tissue perfusion (cold, clammy, mottling skin or altered mental status)

Trauma patients will be included, if at least one cause is suspected:

• Intraabdominal fluid
• Intrathoracic free fluid
• Pneumothorax

Exclusion Criteria:

• age under 18
• if POCUS will lead to a delay of live-saving treatment or transportation

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Point-of-care ultrasound with tele-supervision; Point-of-care ultrasound of critically ill patients (acute dyspnoea, circulatory failure, trauma) will be performed with tele-supervision.	Other: Point-of-care ultrasound with tele-supervision; Point-of-care ultrasound of critically ill patients (acute dyspnoea, circulatory failure, trauma) will be performed with tele-supervision.
Point-of-care ultrasound without tele-supervision; Point-of-care ultrasound of critically ill patients (acute dyspnoea, circulatory failure, trauma) will be performed without tele-supervision.	Other: Point-of-care ultrasound without tele-supervision; Point-of-care ultrasound of critically ill patients (acute dyspnoea, circulatory failure, trauma) will be performed with tele-supervision.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of prehospital ultrasound between POCUS with or without tele-supervision	duration of prehospital ultrasound between POCUS with tele-supervision and POCUS without tele-supervision in critically ill patients (acute dyspnoea, circulatory failure, trauma).	through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Alteration of treatent strategies	Investigating the impact of POCUS with tele-supervision in comparison to POCUS without tele-supervision on alteration of treatment strategies.	through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accuracy of suspected diagnosis in comparison to clinical findings	Investigating the impact of POCUS with tele-supervision in comparison to POCUS without tele-supervision on accuracy of suspected diagnosis in comparison to clinical findings.	through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: Medical University of Vienna

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2021
• Primary Completion (Anticipated): December 31, 2022
• Study Completion (Anticipated): December 31, 2022

Study Registration Dates

• First Submitted: March 16, 2021
• First Submitted That Met QC Criteria: March 18, 2021
• First Posted (Actual): March 23, 2021

Study Record Updates

• Last Update Posted (Estimate): January 10, 2023
• Last Update Submitted That Met QC Criteria: January 6, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Keywords: Ultrasound diagnostics; Prehospital emergency medicine
• Other Study ID Numbers: 1218/2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No