Ultrasound use in Kent, Surrey and Sussex Air Ambulance: a survey
© Tresman et al. 2015
Published: 11 September 2015
Kent Surrey and Sussex (KSS) air ambulance utilize a portable ultrasound (US) scanning machine with a high frequency linear probe. Current standard operating procedure (SOP) states it should be used as an adjunct to chest assessment. Formal indications for pre-hospital US use are not yet established despite many theoretical uses in the literature.
This study aimed firstly to assess the use of ultrasound in the unit. Secondly, to survey views on indications for pre-hospital US and finally to audit training and confidence levels within the unit.
A survey of 17 air ambulance practitioners who attended clinical governance days was undertaken. This consisted of 9 doctors and 8 paramedics/critical care paramedics. The questionnaire was drafted with assistance from the KSS research and audit lead.
69% of clinicians estimated US use in <25% of thoracostomies and 53% estimated use of US in <50% of polytrauma cases. Reasons for not using US varied significantly; the most common being that it would not change management (39%) and a need for thoracostomy regardless (28%). Opinions varied about indications for US, the most popular being thoracic, FAST, cardiac and surgical airway. Training level varied widely; 77.8 % doctors undertook the Level 1 course and 87.5% paramedics had HEMS crew course training. Doctors had a mean confidence in performing thoracic US of 77.8%, and paramedics 67.5%.
Use of US is inconsistent despite inclusion in the SOP. The reason is multifactorial and it is clear from this survey that use and opinion of utility of US varies widely. However, increased formal training, support and supervision could increase use, improve confidence and aid decision making. Despite several possible applications, well designed clinical trials are needed to help define the role of pre-hospital US and courses specific to this may aid uptake of the skill.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.