Quality of prehospital thoracic ultrasound performed by paramedics

Pia Iben Pietersen, Søren Mikkelsen, Annmarie Lassen, Simon Helmerik, Gitte Jørgensen, Giti Nadim, Helle Marie Christensen, Daniel Wittrock, Christian Laursen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review


Background: In a prehospital setting, the initial evaluation, diagnosing, and management of patients with respiratory symptoms can be challenging. Thoracic ultrasound (TUS) can contribute with important information and support clinical decision-making. However, ultrasound is user dependent. The aim was to explore the quality of thoracic ultrasound examinations performed by paramedics in a prehospital setting.Methods: From November 2018–April 2020 paramedics (n=100) performed TUS on patients using a portable ultrasound device. Patients were included if they had made an emergency call due to respiratory symptoms and were assessed by the paramedic to be in a condition that did not require urgent transport. The TUS examinations were retrospectively rated by a blinded reviewer (image quality score 1-5). The findings and change in treatment or management of the patient was correlated with the reviewers using overall agreement in percentage and as Cohen’s kappa.Results: The ultrasound examinations (n=590) were assessed, resulting in a median image quality score of 3 (IQ1=4, IQ3=3). The overall agreement was high (87.7% for a normal scan, 89.9% for interstitial syndrome, 97.3% for possible pneumothorax, 96.3% for pleural effusion). Cohen’s kappa varied from 0.01 (possible pneumothorax) to 0.69 (pleural effusion). The examination entailed a change in treatment or visitation in 48 cases (11.7%) which encompasses a number-needed-to-scan =8.5.Conclusion: Paramedics perform TUS with adequate image quality to determine if pathology is present or not. The paramedics’ assessment correlates to some extent with an experienced reviewer and their findings are most reliable for a normal scan or inclusion of pleural effusionFootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA4341.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
TidsskriftEuropean Respiratory Journal
Udgave nummersuppl 65
StatusUdgivet - 5. sep. 2021
BegivenhedERS International Congress 2021 -
Varighed: 5. sep. 20218. sep. 2021


KonferenceERS International Congress 2021


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