Observational studyPrehospital emergency care2026
Interpretation Accuracy and Theoretical Decision Impact of Prehospital Ultrasound for Paramedics - Analysis of a Rural Pilot Program.
Observational study in Prehospital emergency care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
Funding
Abstract
objectivesFocused, limited-scope prehospital ultrasound (PHUS) has become increasingly feasible for paramedics to learn and implement. However, the impact of ultrasound findings on paramedic clinical decisions has not been well examined. In this pilot program, we investigated the accuracy of paramedic interpretation and theoretical impact of ultrasound findings on clinical decisions in a small rural pilot program of PHUS in the state of New Hampshire.
methodsIn this prospective observational cohort study, five experienced paramedics performed 47 total exams during patient care, including focused assessment with sonography in trauma (eFAST) (
resultsAmong all exam types, 39 (83%) were accurately interpreted with adequate windows, 7 (15%) were indeterminate from incomplete windows, and only one (2%) was truly inaccurate. Paramedics reported that 10 (8%) exams would have impacted their decisions if integrated into care, 55 (46%) would have supported the decision that they made without PHUS, and 54 (45%) would not have impacted their decision. Overall, 32 (63%) pulmonary, 23 (64%) eFAST, and 10 (31%) cardiac exams would support or impact their decisions (
conclusionsTrained, experienced paramedics can acquire and accurately interpret focused PHUS exams in the field. Incomplete windows were the most frequent source of interpretation error. Paramedics reported that PHUS findings would support or impact their clinical decisions in the majority of uses, with pulmonary and eFAST providing the most decision support of exams studied. These results support growing evidence that PHUS may support prehospital decisions and patient care in focused, protocolized use cases in rural settings.
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