ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
Implementation of prehospital point-of-care ultrasound using a novel continuous feedback approach in a UK helicopter emergency medical service.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Pre-hospital and emergency department point-of-care ultrasound in cardiovascular emergencies: a scoping review.Cardiovascular diagnosis and therapy · 2026Review
- Point-of-care ultrasound in prehospital emergency care: attitudes, facilitators and barriers.BMC medical education · 2026Article
- Real world evaluation of a distance-supervised ultrasound training programme in a physician-staffed emergency medical service: a prospective, descriptive implementation study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Defining minimum image quality criteria for common diagnostic point-of-care ultrasound images: A position statement of the Society of Hospital Medicine.Journal of hospital medicine · 2026Review
- Point-of-care ultrasound during trauma and critical care transport: a practical, safety-gated review.Frontiers in public health · 2026Review
- Knowledge and Awareness of Volume Assessment Among Emergency and Intensive Care Physicians in Saudi Arabia.Cureus · 2025Article
- Echoes of precision: feedback, governance and ultrasound in prehospital care.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThere has been increased use of prehospital point-of-care ultrasound (PoCUS) by helicopter emergency medical services (HEMS) in recent years. Lack of governance structure and evidence of benefit have been described as major barriers to its implementation. This paper describes a novel approach to implementation of prehospital PoCUS and clinical governance framework in a UK HEMS.
methodsA retrospective database review was undertaken at London's Air Ambulance (LAA) from 1st September 2021 to 31st March 2023. All patients who had PoCUS examination were included. Scans were archived in a cloud-based server and reviewed weekly by expert clinicians. They were graded in adequacy, agreement between reviewer and clinician was recorded and fed back to the clinicians allowing continuous feedback learning. In-hospital diagnosis was sought for patients having the full Pump, Pleura and Pouring blood (PPPB) protocol. Cohen's Kappa (ƙ) was calculated for inter-rater reliability. Sensitivity and specificity analysis was performed using 2 × 2 tables.
resultsLAA attended 3,068 missions. Our reviewers identified 701 PoCUS scanning encounters and 628 were included in the final analysis. Clinicians performed 420 scans for pneumothorax, 308 for free fluid and 305 pericardial effusions respectively. Majority of the population were male (85%) who sustained traumatic (93.5%) thoracic injuries (65%). Paramedics performed 29% of the scans. Reviewers deemed 83% of the scans of adequate quality. Inter-rater reliability between clinicians and reviewers was 0.6 for pericardial effusion, 0.67 for pneumothorax and 0.71 for free fluid respectively. A full PPPB protocol was performed in 52 patients out of which 46 were included. The sensitivity and specificity of PPPB protocol for diagnosis life-threatening injuries was 0.5 and 0.9 respectively.
conclusionIntroduction of prehospital PoCUS in a HEM service utilizing high quality training, user-friendly workflow and image archiving system, robust governance framework and continuous feedback may be feasible allowing high quality ultrasound examinations. The bespoke PPPB protocol in prehospital may improve diagnosis of life-threatening injuries.
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