Sonography in Pre-Hospital EMS

By: Logan Goettsch, B.S., EMT-P

April 27th, 2015

Cell phones on silent please!

Ultrasound Sonography in EMSBenefits?• Allows internal views

of anatomy with a portable device

• Quick• Safe• Pain free• Early Recognition!!!

Ultrasound: What is it?• Sound waves

(humans can’t hear)• Frequency? • Animals?

How Can It Help EMS???Technology that leads to faster diagnosis!!!• Early Recognition• Early notification• Correct Destination• Save Time = Save

Lives

Pregnancy EmergenciesReal Scenario Odessa FD:MVA-Pregnant F in in her 36th week of pregnancy. Head on collision at 35 mph, lap and shoulder belt w/ airbag deployment, presenting with supra pubic pain and bruising.

Concerns?

Multi-System TraumaReal Scenario:28 y/o M high speed roll-over with ejection. GCS 15 with bilateral closed femur fractures and RU quadrant undiagnosed abdominal pain. BP 128/80, P 98, RR 20. Ground transport 40 minutes to trauma facility w/ no available air transport.

• Initial thoughts on treatment?

No free fluid noted!!!

Advanced Airway Placement

Another method of conforming ET tube or supra glottic placement

• End Tidal CO2 Gold standard!

• (cardiac arrest, low cardiac output, pulmonary embolism, hypothermia)

Cardiac Ultrasound

PE and Asystole arrest field terminations• Being added to other field

termination guidelines

Other Possible Uses in EMS

• Ultrasound Guided Peripheral Venous Access (British study 2010) 90% better!

• Early stroke assessment

• CCT Continuous

monitoring

• Air ambulance (I can’t hear!)

ChallengesCost: the cost of these machines are far too expensive

Training: Most ultrasonography programs are thousands of hours

Delay in Definitive care: to time consuming (FAST), system specific***

Certification: do we need it? NO!

Not Safe (Radiation)- Non-ionized vs Ionized

Focused Assessment Sonography in Trauma

Dr. Yamada

Questions? Comments? Concerns?

Thank You for your time.

Works Cited

(n.d.). Retrieved April 26, 2015, from http://cutebabypictures.org/d/18983-1/ultrasound sonography.PNG(n.d.). Retrieved April 26, 2015, from http://www.uk-ireland.bcftechnology.com/learning/small-animal/technology-explained/~/media/LEARNING ZONE/Articles/Bovine articles/Images/ Ultrasound Testing - Los Angeles Heart Specialists. (n.d.). Retrieved April 26, 2015, from http://www.laheartspecialists.com/services/ultrasound-tersting/(n.d.). Retrieved April 26, 2015, from http://bestpractice.bmj.com/best-practice/images/bp/en-gb/174-4_default.jpg(n.d.). Retrieved April 26, 2015, from http://amaprod.silverchaircdn.com/data/Journals/JAMA/23310/jrc25002f1.png(n.d.). Retrieved April 26, 2015, from http://www.lahey.org/assets/0/71/511/95/219/609/138a2405-1ffc-4c93-8c9d-63bc882a9b85.jpg(n.d.). Retrieved April 26, 2015, from http://www.ultrasoundcases.info/files/Jpg/18417.jpg(n.d.). Retrieved April 26, 2015, from http://cdn8.staztic.com/app/a/1004/1004575/medrills-ncd-for-pneumothorax-34-2-s-307x512.jpgRadiology, News, Education, Service. (n.d.). Retrieved April 26, 2015, from http://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=78061(n.d.). Retrieved April 26, 2015, from http://emergencyultrasoundteaching.com/galleries/image(n.d.). Retrieved April 26, 2015, from http://i.ytimg.com/vi/PuaJ4EHXT18/hqdefault.jpg