Remote real-time supervision of prehospital point-of-care ultrasound: a feasibility study.

Martina Hermann, Christina Hafner, Vincenz Scharner, Mojca Hribersek, Mathias Maleczek, Andreas Schmid, Eva Schaden, Harald Willschke, Thomas Hamp
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Abstract

Background: Although prehospital point-of-care ultrasound (POCUS) is gaining in importance, its rapid interpretation remains challenging in prehospital emergency situations. The technical development of remote real-time supervision potentially offers the possibility to support emergency medicine providers during prehospital emergency ultrasound. The aim of this study was to assess the feasibility of live data transmission and supervision of prehospital POCUS in an urban environment and so to improve patients' safety.

Methods: Emergency doctors with moderate ultrasound experience performed prehospital POCUS in emergency cases (n = 24) such as trauma, acute dyspnea or cardiac shock using the portable ultrasound device Lumify™. The ultrasound examination was remotely transmitted to an emergency ultrasound expert in the clinic for real-time supervision via a secure video and audio connection. Technical feasibility as well as quality of communication and live stream were analysed.

Results: Prehospital POCUS with remote real-time supervision was successfully performed in 17 patients (71%). In 3 cases, the expert was not available on time and in 1 case remote data transmission was not possible due to connection problems. In 3 cases tele-supervision was restricted to video only and no verbal communication was possible via the device itself due to power saving mode of the tablet.

Conclusion: Remote real-time supervision of prehospital POCUS in an urban environment is feasible most of the time with excellent image and communication quality.

Trial registration: ClinicalTrials Number NCT04612816.

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院前点超声远程实时监控的可行性研究
背景:虽然院前点超声(POCUS)越来越重要,但其快速解释在院前紧急情况下仍然具有挑战性。远程实时监控技术的发展为院前急诊超声提供了潜在的可能性。本研究旨在评估院前POCUS在城市环境下实时数据传输和监控的可行性,从而提高患者的安全性。方法:具有中等超声经验的急诊医生使用便携式超声设备Lumify™对创伤、急性呼吸困难或心源性休克等急诊病例(24例)进行院前POCUS。超声检查通过安全的视频和音频连接远程传送给诊所的急诊超声专家进行实时监督。分析了技术可行性、通信质量和直播质量。结果:院前远程实时监护POCUS成功17例(71%)。在3例中,专家没有及时到达,在1例中,由于连接问题,无法远程传输数据。在3例中,远程监控仅限于视频,由于平板电脑的节电模式,无法通过设备本身进行口头交流。结论:院前POCUS在城市环境下的远程实时监控在大多数情况下是可行的,且具有良好的图像和通信质量。试验注册:ClinicalTrials编号NCT04612816。
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