Page 214 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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Chapter 10
Future perspective
As noted before, ultrasound in healthcare will be used more and more often. This increase will undoubtedly continue in the years to come.
This thesis discussed the impact that ultrasonography has on prehospital and emergency medicine, and the additional utility and impact it might have in the future. Furthermore, technological developments such as the shift from piezoelectric crystals to semiconductor chips that enable a single broadband transducer to visualize both deep and superficial struc- tures and sophisticated software fueled by deep learning and artificial intelligence will very soon be on the market. Various transducer types and the differences between them—as dis- cussed in Chapter 3—will probably belong to the past. These developments will significant- ly facilitate acquiring and interpreting relevant, high-quality images, recognizing relevant structures, and taking various measurements. Less-skilled operators will also be able to use ultrasonography to help improve patient care.
Due to current and future applications and technological improvements, it could be ben- eficial to pursue a broader implementation of ultrasonography in the (Dutch) prehospital emergency medical services (EMS) and emergency departments.
First, the high standard of care provided by the Dutch land-based (ambulance) EMS could be even further enhanced by, for instance, guiding endotracheal intubation, facilitating in- travenous access, guiding CPR, providing superior pain relief by means of UGRA, and by detecting or excluding abdominal aortic aneurysms in suspected individuals. The implemen- tation could start by training a selected group of EMS personnel and by adding devices to selected EMS vehicles.
Secondly, the standard inventory of every Dutch HEMS should include an ultrasound device. The HEMS augments the land-based EMS and this augmentation should include additional diagnostic and procedural techniques. Therefore, it is recommended that every HEMS phy- sician is trained in at least the eFAST/PREP protocol and possibly in additional techniques such as airway assessment, intravenous access, and UGRA. Recent developments such as extracorporeal life support (ECLS) and resuscitative endovascular balloon occlusion of the aorta (REBOA) may find their way to Dutch prehospital care and their chance of success will probably benefit from ultrasound. Moreover, any potential benefit of techniques such as ONSD measurements, and transcranial doppler for ischemic stroke should be further investigated.
  


























































































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