Balasubramanian Shriman, DeFilippo Michael, Stone Michael, Galli Gabriela, McCarty Matthew, Daniels Brock
New York Presbyterian Hospital Cornell and Columbia, Department of Emergency Medicine, New York.
Weill Cornell Medicine, Department of Emergency Medicine, New York.
Clin Pract Cases Emerg Med. 2024 Aug;8(3):189-193. doi: 10.5811/cpcem.1296.
The use of telemedicine and ultrasound is emerging and novel in the field of community paramedicine. However, there is a paucity of data supporting its use and even less evidence that shows a morbidity and mortality benefit. This case highlights a unique way to diagnose a common medical emergency, which can lead to a good outcome.
We describe the use of lung point-of-care ultrasound by a trained community paramedic that led to the identification of a pneumothorax in an 86-year-old male at a scheduled home visit. The images were interpreted over telehealth in real-time by an emergency physician, and the patient was transported to the emergency department where the diagnosis was confirmed by chest radiography. He underwent chest tube placement and was discharged five days later after returning to his baseline.
Despite minimal data to support or refute the use of paramedic tele-ultrasound, this case highlights a unique opportunity to expand the use of telemedicine and ultrasound in community paramedicine to improve patient outcomes.
远程医疗和超声在社区护理领域的应用正在兴起且颇具创新性。然而,支持其使用的数据匮乏,甚至更少的证据表明其能带来发病率和死亡率方面的益处。本病例突出了一种诊断常见医疗急症的独特方法,可带来良好预后。
我们描述了一名经过培训的社区护理人员使用肺部床旁超声,在一次预定的家访中对一名86岁男性患者诊断出气胸的情况。图像由一名急诊医生通过远程医疗进行实时解读,患者被送往急诊科,胸部X光检查证实了诊断。他接受了胸腔闭式引流管置入术,五天后恢复至基线状态后出院。
尽管支持或反驳护理人员远程超声使用的数据极少,但本病例突出了一个独特的机会,可扩大远程医疗和超声在社区护理中的应用,以改善患者预后。