Point of care prehospital ultrasound in Basic Emergency Services in Portugal

Lobo, Manuel José Cruz Duarte; Tavares, Sérgio Carlos Castanheira Nunes Miravent; Almeida, Rui

doi:10.1002/hsr2.847

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Further comparative data between radiographers/sonographers and radiologists would be valuable to enhance the existing academic education, both theoretically and practically, and to increase the use of sonographic screening by BES. 7 This benefit of integrating ultrasound performed by radiographers/sonographers and its cost-effectiveness for the National Health System has been documented by Lobo et al 39 Results also emphasize the importance of not disregarding There were some patients with evident biliary pathology who were referred to RH but ended up leaving this medical care facility (leaved the Basic Emergency Center) reducing the representativeness of our sample.…”

Section: Williams Et Al Found High Agreement In Abdominal Sonographymentioning

confidence: 64%

Section: Discussionmentioning

confidence: 89%

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Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service

Tavares

Lobo

Figueiredo

et al. 2023

Health Science Reports

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Background and Aims The use of ultrasound screening is primarily facilitated by point‐of‐care ultrasound (POCUS) and its integration into healthcare systems is a result of the versatility of this imaging technique. This study intends to compare the accuracy and pertinence of sonographic findings obtained by a sonographer in a Basic Emergency Service (BES) with that of radiologists at referral hospital (RH) in Portugal. Methods Twenty patients with right upper quadrant (RUQ) pain and suspected cholecystitis or biliary pathology underwent sonography screening using POCUS in the BES. They were then forwarded to the RH where a radiologist performed a conventional ultrasound exam on the same patients. The results of both exams were compared to determine if the findings obtained in the BES were confirmed by the radiologist in the RH. Results In our sample, 60% of cases were related to biliary pathology, 20% were liver‐related, 10% had hepatopancreatic biliary etiology, and 10% had unknown etiology. A strong association between the sonographic findings in the BES and the RH was found in the variables “Sonographic Murphy sign” ( V = 0.859; p = 0.001), “Cholelithiasis/Gallbladder sludge” ( V = 0.840; p = 0.001), and “Intrahepatic biliary tract dilatation” ( V = 0.717; p = 0.006). Adequate measures of agreement between the findings of the radiographer and radiologist were obtained for the “Sonographic Murphy sign” ( k = 0.664; p = 0.001) and the presence of “Cholelithiasis/Gallbladder sludge” ( k = 0.712; p = 0.000). Conclusion Major biliary abnormalities were detected in patients with RUQ pain in BES using sonography. The correlation between the sonographic findings obtained by the sonographers at BES and those obtained by radiologists at the RH in Portugal was strong, showing that POCUS screening could be extended to other similar settings; however, more studies are needed.

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Section: Williams Et Al Found High Agreement In Abdominal Sonographymentioning

confidence: 64%

Section: Discussionmentioning

confidence: 89%

Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service

Tavares

Lobo

Figueiredo

et al. 2023

Health Science Reports

Self Cite

View full text Add to dashboard Cite

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“…In addition to the studies centered around African countries, other papers were concentrated in Central/South American and Caribbean countries such as Nicaragua [33], Guatemala [35,37], Haiti [39], Panama [47], and Brazil [55]. Furthermore, developed countries with western medicine, who incorporated POCUS into their medical institutions in Portugal [46], United States [48,56], New Zealand (rural hospitals) [50][51][52][53][54], United Kingdom [23], Newfoundland and Labrador, were analyzed [58]. More specifically, all of the New Zealand-based papers that were reviewed selected five to six rural hospitals to examine, many of which were dispersed to represent various communities within the rural areas of New Zealand [53][54][55][56][57].…”

Section: Setting and Contextmentioning

confidence: 99%

“…In addition, POCUS was prevalent in emergency and trauma settings across various applications, utilizing FAST and Extended Focused Assessment with Sonography in Trauma (E-FAST) [46,48,57]. Epstein et al studied the effectiveness of POCUS on patients in Uganda presenting with trauma casualties, shock, cardiorespiratory symptoms, and those undergoing invasive procedures [38].…”

Section: Clinical Applications Of Pocusmentioning

confidence: 99%

“…We note that POCUS devices have the potential to be utilized in a much larger context within LRS, extending beyond the applications we discussed. In developed countries, these devices are heavily employed in general practice or even trauma settings to make instantaneous point-of-care decisions crucial to a patient's life [46,57]. There was only a singular similar study in LRS that reported a 3% negative impact due to the use of POCUS imaging [51].…”

Section: Clinical Applications Of Pocus In Lrsmentioning

confidence: 99%

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From Seeing to Knowing with Artificial Intelligence: A Scoping Review of Point-of-Care Ultrasound in Low-Resource Settings

Venkatayogi,

Gupta,

Gupta

et al. 2023

Applied Sciences

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The utilization of ultrasound imaging for early visualization has been imperative in disease detection, especially in the first responder setting. Over the past decade, rapid advancements in the underlying technology of ultrasound have allowed for the development of portable point-of-care ultrasounds (POCUS) with handheld devices. The application of POCUS is versatile, as seen by its use in pulmonary, cardiovascular, and neonatal imaging, among many others. However, despite these advances, there is an inherent inability of translating POCUS devices to low-resource settings (LRS). To bridge these gaps, the implementation of artificial intelligence offers an interesting opportunity. Our work reviews recent applications of POCUS devices within LRS from 2016 to 2023, identifying the most commonly utilized clinical applications and areas where further innovation is needed. Furthermore, we pinpoint areas of POCUS technologies that can be improved using state-of-art artificial intelligence technologies, thus enabling the widespread adoption of POCUS devices in low-resource settings.

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Point-of-care ultrasound use in austere environments: A scoping review

Anderson,

Theophanous

2024

PLoS ONE

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Background/Objectives Technological developments in point-of-care ultrasound (POCUS), particularly with portable devices, are transforming POCUS use in austere, resource-limited environments (RLS) distinct from typical hospital or medical settings. POCUS has potential to improve diagnostic accuracy in military combat zones, low-resource environments such as the desert or tropics, microgravity, and high altitudes. Our updated narrative scoping review describes POCUS use in these global settings. Methods Using the PRISMA-ScR guidelines, two ultrasound-trained emergency physicians searched PubMed, Embase, and Web of Science on August 6, 2024 for “point-of-care ultrasound in austere environments” and each individual category. Study titles and abstracts were independently screened, then full manuscripts, and data was abstracted with a data collection table. 324 articles met inclusion criteria: research studies describing POCUS in austere environments; involving healthcare professionals; and in English. We excluded abstracts, studies not involving POCUS in austere environments, and non-clinical studies. Reviewers critically appraised studies using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) Quality Assessment Tool. Results There were 39 military or conflict zone studies, 101 prehospital, 148 in RLS including low- and middle-income countries, 12 outer space, 15 high altitude, and 32 involving POCUS use in multiple austere environments. There were 6 randomized-control trials, 11 systematic/scoping reviews, 13 narrative reviews, 112 prospective observational/cohort, 34 prospective cross-sectional studies, 23 retrospective, 6 feasibility, 45 case reports, 13 case series, and 5 educational curriculum studies. GRADE study quality was variable, with 74 high quality, 129 moderate, 82 low, and 56 very low. Conclusion The existing literature is mixed with variability in study settings, design, and POCUS examination types, providing an initial understanding of POCUS applications. Most studies are in RLS or prehospital settings. Additional high-quality studies are needed to guide POCUS training, disseminate use in non-hospital settings, and maximize impact for improved clinical outcomes in diverse austere environments.

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Point of care prehospital ultrasound in Basic Emergency Services in Portugal

Cited by 5 publications

References 33 publications

Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service

Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service

From Seeing to Knowing with Artificial Intelligence: A Scoping Review of Point-of-Care Ultrasound in Low-Resource Settings

Point-of-care ultrasound use in austere environments: A scoping review

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