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远程实时监管院前即时超声检查:一项可行性研究。

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

机构信息

Department of Anaesthesia, General Intensive Care and Pain Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria.

出版信息

Scand J Trauma Resusc Emerg Med. 2022 Mar 24;30(1):23. doi: 10.1186/s13049-021-00985-0.

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.

摘要

背景

尽管院前即时超声(POCUS)的重要性日益增加,但在院前紧急情况下,其快速解读仍然具有挑战性。远程实时监护的技术发展为院前急救超声提供了支持急救医务人员的可能性。本研究旨在评估在城市环境中进行院前 POCUS 实时数据传输和监护的可行性,以提高患者的安全性。

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紧急情况进行院前 POCUS 检查(n=24)。超声检查通过安全的视频和音频连接远程传输给诊所内的急救超声专家进行实时监护。分析技术可行性以及通信和实时流的质量。

结果

在 17 名患者(71%)中成功进行了远程实时监护下的院前 POCUS。在 3 例中,专家未能及时到位,在 1 例中,由于连接问题,无法进行远程数据传输。在 3 例中,由于平板电脑的省电模式,只能进行视频监控,而无法通过设备本身进行语音通信。

结论

在城市环境中,远程实时监护院前 POCUS 大多数情况下是可行的,具有出色的图像和通信质量。

临床试验注册号

NCT04612816。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f8/8944068/3a1d9bc447c7/13049_2021_985_Fig1_HTML.jpg

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