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Why we must adapt and adopt

EMS1.com News

June 24, 2010


EMS News in Focus
by Arthur Hsieh

Why we must adapt and adopt

Editor's note: This article is in response to the story "US Study: Medics can do ultrasonography in a moving ambulance." New research confirms paramedics can obtain and interpret ultrasonograms in the back of moving ambulances, a common practice in parts of Europe but still in 'early development stage' in the United States. Read the full story and tell us what you think in the member comments below.

The EMS technological march continues. This article demonstrates that EMS personnel can successfully perform an abdominal ultrasound in the field and accurately interpret the result. The study is small; 40 paramedics who performed the procedure on 104 patients. It would be good to see if the same results would occur with a much larger population of providers.

We've seen this happen in the past; for example, endotracheal intubation with rapid sequence induction (RSI) has been demonstrated to be very successful with small groups of highly trained prehospital personnel — mostly flight crews — but it's been challenging to show similar results with larger, ground-based EMS systems.

Of course, the risk is decidedly less with FAST exams versus advanced airway management, but similar principles apply — our procedures and processes should be reasonably easy to achieve under most circumstances.

The data also supports the concept that a large part of EMS function is as an early notifier for the continuum of care. We do this now for acute coronary syndrome (ACS) and stroke; it makes sense that if we could continue to shave time off of highly time-dependent conditions, we should adapt and adopt.

It would be great to understand whether devices like these can help reduce morbidity and mortality. Studies in prehospital use of continuous positive airway pressure in CHF, and 12-lead EKG acquisition in ACS has shown positive benefit. If you work in systems that are studying the effectiveness of new biotechnology in the field, I'd love to hear from you in the comments below.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at Art.Hsieh@ems1.com.
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