Remote Real-Time Supervision of Prehospital Point-of-Care Ultrasound: A Feasibility Study

Abstract

Background: Although prehospital point-of-care ultrasound (POCUS) is gaining in importance, its rapid interpretation remains challenging in prehospital emergency situations. The technical development of remote real-time supervision potentially offers the possibility to support emergency medicine providers during prehospital emergency ultrasound. The aim of this study was to assess the feasibility of live data transmission and supervision of prehospital POCUS in an urban environment.Methods: Emergency doctors with moderate ultrasound experience performed prehospital POCUS in emergency cases (n=24) such as trauma, acute dyspnea or cardiac shock using the portable ultrasound device LumifyTM. The ultrasound examination was remotely transmitted to an emergency ultrasound expert in the clinic for real-time supervision via a secure video and audio connection. Technical feasibility as well as quality of communication and live stream were analysed.Results: Prehospital POCUS with remote real-time supervision was successfully performed in 17 patients (71%). In 3 cases, the expert was not available on time and in 1 case remote data transmission was not possible due to connection problems. In 3 cases tele-supervision was restricted to video only due to power saving mode of the tablet.Conclusion: Remote real-time supervision of prehospital POCUS is feasible most of the time with excellent image and communication quality. Trial registration: ClinicalTrials Number NCT04612816

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“…Rather than focusing on supporting individuals who are practicing on their own, services could be reconfigured in a way that would facilitate closer teamwork. With the assistance of modern communication technology, it would be relatively easy to organize services such that expert examiners could support directly, or remotely, a relatively large number of sonographers in real time 16 . This support could include assistance with technical aspects of the examination, help with diagnosis and advice on management and follow-up.…”