Page 148 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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Chapter 6
Conclusion
A portable US examination is used, in addition to historytaking and physical examination, in the prehospital setting with increasing frequency. In our region this has led to a decrease in the time needed for an US examination.
High sensitivity, specificity, PPV, and NPV of US allow physicians to make an early and ac- curate diagnosis, which can lead to changes in preliminary treatment decisions, although this can be influenced by many factors. Image quality was influenced by body weight.
Fewer chest tubes than planned were inserted after US was performed, and so a US exam- ination reduced unnecessary invasive treatments. More patients were transported to a low- er-level ED, and fewer patients to a Level I trauma center, compared to our intention before the US examination.
Prospective studies with patient follow-up are needed to determine the value of prehospital US examination performed by a HEMS operating in the Dutch health care system. It must be further elucidated whether US is truly a useful addition in the treatment and management of outof- hospital emergencies.
Acknowledgements
We gratefully acknowledge Geert-Jan van Geffen and Eric N. Robertson for reading and commenting on the manuscript.
