Page 65 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars

Conclusions
We have provided a comprehensive summary of the literature on prehospital applications of diagnostic and therapeutic ultrasound structured according to the ABCDE approach. Also, we have highlighted in-hospital US procedures that appear useful and plausible for prehospital use, current challenges in PHUS, and potential future applications. It may be commendable to revise this review in the near future when, undoubtedly, additional useful PHUS applications will have emerged.
Improvements in portability, quality, and price of handheld ultrasound systems add to the accessibility and its feasibility for prehospital use. PHUS improves the diagnostic capabili- ties of prehospital health care providers and might improve treatment decisions, prearrival notifications, and transport mode and destination. As new PoCUS techniques and applica- tions are being researched, new protocols are being tested for diagnostics, procedural guid- ance, and therapeutic use.
However, prehospital caregivers should unabatedly be aware of the limitations of PHUS. The time investment will not always pay off and diagnostic accuracy isn’t perfect. Diagnostic accuracy is quite dependent on training and experience of the providers.
The diagnostic and therapeutic possibilities of PoCUS are increasing. With promising tech- niques, such as sonothrombolysis in ischemic stroke, we are bringing the hospital-level med- ical care to prehospital patients to an ever-increasing extent.119
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