Clinical applicability of real-time, prehospital image transmission for FAST (Focused Assessment with Sonography for Trauma)

Abstract

We evaluated a real-time, prehospital ultrasound image transmission system for use in focused assessment with sonography for trauma (FAST). The wireless, real-time ultrasound image transmission system comprised an ultrasound scanner with a convex abdominal transducer and a notebook computer connected to a 3 G wireless network for video data transmission. In our simulation experiment, ultrasonography was performed by emergency medical technicians (EMTs) on a human body phantom with simulated haemoperitoneum. Transmitted ultrasound video clips were randomly rearranged and presented to emergency physicians to make a diagnosis of haemoperitoneum. A total of 21 ultrasound video clips was used and 13 emergency physicians participated in the study. The sensitivity and specificity were 90.0% (95% Confidence Interval, CI, 83.5-94.6) and 85.3% (95% CI 78.4-90.7) respectively, and the accuracy of detecting abnormal ultrasound results was 87.7% (95% CI 83.8-91.6). Diagnosis of hemoperitonuem in trauma patients by an emergency physician based on the transmitted video images of FAST performed by an EMT is feasible, and has an accuracy of about 88%.

Barriers to point-of-care ultrasound use in rural emergency departments

“…32 Assuming instant availability of a trained physician at any time to "tele-mentor," this method could be both accurate and feasible. [33][34][35][36][37][38][39] However, limitations include mentor availability, a need for high-bandwidth Internet or cellular connections to maintain image quality, and technical problems such as image freezing. 39,40 Its effectiveness in clinical use has not yet been studied in rural Canada.…”

Training paramedics in focussed echo in life support

“…Several studies have tested the feasibility of paramedicconducted ultrasound, which is overseen by a physician based at the receiving hospital. This involves live streaming of images to an awaiting doctor for interpretation, alongside guidance to the paramedic sonographer [9,10]. Although this system allows real-time interpretation of ultrasound images and facilitates preparation at the receiving ED, it requires a dedicated physician and relies on effective image transmission.…”

Prehospital Telemedical Emergency Management of Severely Injured Trauma Patients

“…65 Just prior to leaving the site, paramedics transmit these data to the receiving ED as initial pre-arrival information. 65,70,73,74 TUS describes the telemedical assistance and guidance in ultrasound examination of mostly untrained paramedics by remote specialist. In terms of trauma, TUS is used to detect fluid retention in the abdominal and thoracic cavities, and thus, to evaluate the urgency of treatment.…”

“…In terms of trauma, TUS is used to detect fluid retention in the abdominal and thoracic cavities, and thus, to evaluate the urgency of treatment. [74][75][76] ►Table 2 summarizes the generic key components of the telemedical concepts in prehospital trauma care and describes the technical solutions involved.…”