scoobymedic96 Posted June 8, 2009 Share Posted June 8, 2009 Hi yall, I was just wondering if any of yall are useing ultrasounds on your trucks. Are ya? We have just had them rolled out to us in our IST program. Not sure yet if we like them. They haven't been put on the trucks yet we have to be able to locate 3 different organs within 20 secs to be able to use them on the trucks. I am curious as to how they work with the truck moving and how good of a picture we are actually gonna get. So any input yall might have would be great. Be Safe Yall Link to comment Share on other sites More sharing options...
FireMedic65 Posted June 8, 2009 Share Posted June 8, 2009 Sounds like a good idea. Though, I don't fully see the point unless you go through radiology training. To know what you are looking for and what you are seeing. If you are looking for internal bleeding, it can be hard to pick up, especially if you aren't sure what you are even looking at through the monitor. As for movement of the vehicle, I suspect you would get a poor image due to all the vibrations. Usually when ultrasounds are done in the hospital, from what I have seen, you are asked to hold your breath to minimize movement. Not sure if this is for other reasons though. Link to comment Share on other sites More sharing options...
VentMedic Posted June 8, 2009 Share Posted June 8, 2009 (edited) While are your transport times? How much extra time in total will be spent at scene using the US device? Do you not already have trauma criteria or other facility determination in place to determine appropriate destination? How well trained are you in all patient ages, sizes and body position? How many live patients, of various sizes and ages, will you have to demonstrate your skills on before being allowed to utilize the US in the field? What additional treatment protocols, skills and meds are implemented? What will change in your overall treatment of the patient? Are you still going to go with the other vital signs, symptoms and MOI to provide treatment regardless of what the US may or may not show? Are you "ruling in" or "ruling out"? If you have lengthy transport times and the appropriate advanced protocols to treat your findings differently than how you do now, it might be appropriate. If you are only looking at three organs with a limited focus, you may not be looking for other possibilities that could also be life threatening or require treatment at a specialized center. A false sense of security could be given if the findings appear normal just from age, size and body position but the patient condition still warrants treatment. Or, you may not have had that chapter for abnormal findings. Portable US can be of very high quality but unfortunately it often becomes an expensive vein finder rather than being used for its intended purpose. US is used by some Specialty and Flight teams but if it doesn't change what you do, it becomes just another piece of equipment that requires careful storing and maintenance. It may also take a few minutes away from something else that also needs to be done and if you only have one Paramedic with an EMT partner on scene, this could be crucial. If it is used too infrequently, more time may be lost and a greater margin of error by lack of familiarity may influence findings. Will extra training sessions in a hospital be setup to periodically review? (Like the ones so many do to keep their ETI skills perfected.) Edited June 8, 2009 by VentMedic Link to comment Share on other sites More sharing options...
scoobymedic96 Posted June 8, 2009 Author Share Posted June 8, 2009 While are your transport times? anywhere from less than 10min up to 60min all depending on call location in the county and which facility we r going to. How much extra time in total will be spent at scene using the US device? none we are to do enroute is the way i understand it Do you not already have trauma criteria or other facility determination in place to determine appropriate destination? we do already have How well trained are you in all patient ages, sizes and body position? no extra training at the moment How many live patients, of various sizes and ages, will you have to demonstrate your skills on before being allowed to utilize the US in the field?as i understand it 1 adult male pt locate 3 organs within 20 secs, organs to be determined by evaluator What additional treatment protocols, skills and meds are implemented? none to my knowledge What will change in your overall treatment of the patient? Are you still going to go with the other vital signs, symptoms and MOI to provide treatment regardless of what the US may or may not show? Are you "ruling in" or "ruling out"? ruling out i believe If you have lengthy transport times and the appropriate advanced protocols to treat your findings differently than how you do now, it might be appropriate. If you are only looking at three organs with a limited focus, you may not be looking for other possibilities that could also be life threatening or require treatment at a specialized center. A false sense of security could be given if the findings appear normal just from age, size and body position but the patient condition still warrants treatment. Or, you may not have had that chapter for abnormal findings. Portable US can be of very high quality but unfortunately it often becomes an expensive vein finder rather than being used for its intended purpose. US is used by some Specialty and Flight teams but if it doesn't change what you do, it becomes another piece of equipment that requires careful storing and maintenance. It may also take a few minutes away from something else that also needs to be done and if you only have one Paramedic (EMT partner) on scene, this could be crucial. If it is used too infrequently, more time may be lost and a greater margin of error by lack of familiarity may influence findings. Link to comment Share on other sites More sharing options...
Jeepluv77 Posted June 8, 2009 Share Posted June 8, 2009 I hate to say it, because I would love to be able to use an ultrasound, but really how much good is it going to do? Even if you find an internal bleed, there really isn't going to be much you can do in the field. Even a surgeon wouldn't be able to because of the lack of a sterile environment. Like VentMedic said, however, it could help to determine the need for a specialized hospital. Here though if we expect an internal bleed due to MOI they would go to the nearest hospital equipped for that anyway even in the absence of immediate signs and symptoms. I understand that may be different in other areas as we are lucky enough to have a level one trauma center nearby and a level two center(that's damn near a level one, just barely doesn't qualify as they occasionally will be missing one or two specialists) in my city. I would suspect, then, that this technology would be a waste of money in an area like mine but a huge benefit(when properly used) in a more rural area. Or, for that matter, in a place like NYC were transport to a level one center could be complicated by heavier traffic to have to navigate. Link to comment Share on other sites More sharing options...
WestSideBorderPatrol Posted June 8, 2009 Share Posted June 8, 2009 As for movement of the vehicle, I suspect you would get a poor image due to all the vibrations. Usually when ultrasounds are done in the hospital, from what I have seen, you are asked to hold your breath to minimize movement. Not sure if this is for other reasons though. When they ask you to hold your breath, it has to do with the position of the diaphragm and how it moves the other organs into a better viewing position. I asked that question when I had a US on my kidney. Link to comment Share on other sites More sharing options...
Neup Posted June 11, 2009 Share Posted June 11, 2009 Assuming that it is accompanied by the proper training, I could see where this would be a valuable tool. Apparently your med director has approved of US use, but how supportive are they? How is your training program for other skills and equipment? Link to comment Share on other sites More sharing options...
2wheelinemt Posted June 11, 2009 Share Posted June 11, 2009 I truely don't see how this will help with treatment of the pt. Even if you see a liver bleed, I still dont understand how that will change the way that you ill treat someone in the back of the rig. It's not like we are going to be doing surgery in the back of the rig, I can see that you will be able to alert trauma team what you really have as a posed to just advising them of a rigid abd or anything like that, you'll have what is really wrong with the pt. So if the thing works as good as maybe it should might not be a bad idea. But I haven't a company make equipment worthy of the bouncing and everything else that ems put equipment through. Even the computers have taken awhile, in my 23 years they have tried so many different gadgets but the back of the rig is a tuff place for the equipment. My oly concern is that the emts will be too busy using that instead of the orginial way that thy were taught especially with the special gift of touch!!!! What state do you live in if you don't mind me asking, just curious. Thanks and good luck with it! Keep me updated how things go with you and your new toy! 2wheelie ' Link to comment Share on other sites More sharing options...
FireMedic65 Posted June 11, 2009 Share Posted June 11, 2009 When they ask you to hold your breath, it has to do with the position of the diaphragm and how it moves the other organs into a better viewing position. I asked that question when I had a US on my kidney. Thanks for clarifying I was always curious, but didn't want to be "that guy" to ask the dumbest question of the day. Link to comment Share on other sites More sharing options...
spenac Posted June 11, 2009 Share Posted June 11, 2009 http://www.911sono.com/ It has been used with great success in some services. It has helped speed the patient getting proper care rather than delaying proper care. This like the 12 lead do not add that much time on scene yet actually can improve patient care. Those that oppose seem to just want us to be taxi drivers rather than Pre Hospital Medical Professionals. Link to comment Share on other sites More sharing options...
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