Ultrasound as a Tool in Prehospital Settings: Scoping review.

Abstract

Prehospital ultrasound (POCUS) is emerging as a valuable tool in the management of critically ill patients, particularly in trauma, dyspnea, and shock. This review aims to evaluate the diagnostic and therapeutic applications, limitations, and implementation challenges of POCUS in prehospital care. Key findings demonstrate that ultrasound, particularly the eFAST protocol, offers high specificity in identifying severe hemorrhage in trauma cases, although its sensitivity varies depending on the clinical context and operator experience. In dyspnea, pulmonary ultrasound significantly enhances diagnostic accuracy, aiding early detection of heart failure and other respiratory conditions. For shock, focused echocardiography facilitates rapid diagnosis and timely therapeutic decisions, improving patient outcomes. However, the effectiveness of POCUS is highly dependent on the operator's expertise, and challenges such as time, space, and resource limitations in prehospital settings may impact its use. Furthermore, there is a lack of local studies in Latin America assessing the impact of prehospital ultrasound on morbidity and mortality reduction, highlighting a gap in research. The review recommends standardized training programs, increased availability of portable ultrasound devices, and prospective studies on cost-benefit analysis to optimize POCUS implementation in prehospital systems, particularly in resource-limited regions. Prehospital ultrasound has the potential to revolutionize patient care by improving diagnostic precision and reducing time to definitive treatment, but its successful implementation requires strategic integration of technology, education, and research.