Live Stream of Ultrasound in Prehospital Medical Care

Ultrasound Clinical Trial

Official title:

Live Stream of Emergency Ultrasound to Improve Diagnostics in Prehospital Medical Care: a Feasibility Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04612816
• Other study ID #: Prehospital Ultrasound LBI/MUV
• Status: Completed
• Start date: October 19, 2020
• Est. completion date: August 31, 2021

Study information

• Verified date: September 2021
• Source: Medical University of Vienna
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 25
• Est. completion date: August 31, 2021
• Est. primary completion date: August 31, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 116 Years

Eligibility

Inclusion Criteria:

Emergency patients affected by:

• trauma

• cardiac arrest/shock

• respiratory problems

Exclusion Criteria:

• Patients rejection.

• Legal representative's rejection.

Related Conditions & MeSH terms

• Ultrasound

Intervention

Other:
• Prehospital ultrasound
Feasibility of real time PEU transmission in a university affiliated preclinical emergency system.

Locations

Country	Name	City	State
Austria	Medical University of Vienna - Division of General Anaesthesia and Intensive Care Medicine	Vienna

Sponsors (1)

Lead Sponsor	Collaborator
Medical University of Vienna

Country where clinical trial is conducted

Austria, 

References & Publications (6)

Bøtker 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. Review. — View 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. Review. — View 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. Review. — View 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. — View 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. Review. German. — View 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. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Quality of PEU live stream.	Numerical scale (1-10; 1 = best, 10 = poor)	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Expert available on time? Communication? Duration of ultrasound examination? Duration of live stream? Delay by PEU transmission? Emergency duration with/without PEU transmission Technical problems?	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Communication?	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Duration of ultrasound examination?	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Duration of live stream?	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Delay by PEU transmission?	3 Months
Secondary	Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.	Emergency duration with/without PEU transmission technical problems?	3 Months