Clinical trial NCT04612816: Live Stream of Ultrasound in Prehospital Medical Care
Official title: Live Stream of Emergency Ultrasound to Improve Diagnostics in Prehospital Medical Care: a Feasibility Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Ultrasound
Keywords: echocardiography
emergency medicine
telemedicine
Lead sponsor: Medical University of Vienna
Sponsor class: OTHER
First posted: 2020-11-03
Enrollment: 25
Sex: ALL
Minimum age (years): 18
Maximum age (years): 116
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems.

Brief summary: Prehospital emergency ultrasound (PEU) is being increasingly used in different preclinical emergency systems across the world. Ultrasound examinations in emergency situations, however, remain challenging even in the hospital setting despite the availability of standardized approaches such as Focused Assessment with Sonography for Trauma (FAST). Preclinical circumstances further complicate the adequate execution of an additional diagnostic tool such as PEU on the scene or inside a medical emergency vehicle. Furthermore, rapid translation of ultrasound findings into meaningful therapeutic consequences is considerably demanding in an environment of limited resources. If focused PEU is correctly used and patients' condition allows emergency doctors a careful ultrasound examination, it is possible to differentiate life-threatening diagnoses. PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems. To date it is unclear whether PEU results in improved outcome.

Some emergency cases present difficult challenges in the prehospital ultrasound examination. Portable devices designed for PEU suggest the possibility of increasing the use of ultrasound "in the field". However, to the investigator's knowledge, opportunities for real-time consultation with a second specialist including live transmission of the ultrasound picture are not being provided at any preclinical emergency facility.

Detailed description: Aim 1:

Feasibility of real time prehospital emergency ultrasound (PEU) transmission in a university affiliated preclinical emergency system.

Aim 2:

Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.

Hypothesis:

We expect that live streaming of emergency ultrasound images in order to allow a second opinion could improve diagnostics of life threatening conditions and help us to improve patients' safety by digital health. The use of PEU is feasible and safe.

Eligibility criteria: Inclusion Criteria:

Emergency patients affected by:

* trauma
* cardiac arrest/shock
* respiratory problems

Exclusion Criteria:

* Patients rejection.
* Legal representative's rejection.

Primary outcomes:
measure: Quality of PEU live stream.
timeFrame: 3 Months
Secondary outcomes:
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
measure: Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.
timeFrame: 3 Months
Other outcomes:
Locations:
city: Vienna
country: Austria
facility: Medical University of Vienna - Division of General Anaesthesia and Intensive Care Medicine
Study officials:
References:
citation: Botker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma Resusc Emerg Med. 2018 Jun 26;26(1):51. doi: 10.1186/s13049-018-0518-x.
citation: van der Weide L, Popal Z, Terra M, Schwarte LA, Ket JCF, Kooij FO, Exadaktylos AK, Zuidema WP, Giannakopoulos GF. Prehospital ultrasound in the management of trauma patients: Systematic review of the literature. Injury. 2019 Dec;50(12):2167-2175. doi: 10.1016/j.injury.2019.09.034. Epub 2019 Sep 28.
citation: Scharonow M, Weilbach C. Prehospital point-of-care emergency ultrasound: a cohort study. Scand J Trauma Resusc Emerg Med. 2018 Jun 18;26(1):49. doi: 10.1186/s13049-018-0519-9.
citation: Ketelaars R, Reijnders G, van Geffen GJ, Scheffer GJ, Hoogerwerf N. ABCDE of prehospital ultrasonography: a narrative review. Crit Ultrasound J. 2018 Aug 8;10(1):17. doi: 10.1186/s13089-018-0099-y.
citation: Marsh-Feiley G, Eadie L, Wilson P. Telesonography in emergency medicine: A systematic review. PLoS One. 2018 May 3;13(5):e0194840. doi: 10.1371/journal.pone.0194840. eCollection 2018.
citation: Schmid M, Dodt C. [Emergency lung ultrasound]. Med Klin Intensivmed Notfmed. 2018 Nov;113(8):616-624. doi: 10.1007/s00063-018-0485-z. Epub 2018 Oct 10. German.
citation: Hermann M, Hafner C, Scharner V, Hribersek M, Maleczek M, Schmid A, Schaden E, Willschke H, Hamp T. Remote real-time supervision of prehospital point-of-care ultrasound: a feasibility study. Scand J Trauma Resusc Emerg Med. 2022 Mar 24;30(1):23. doi: 10.1186/s13049-021-00985-0.