Remote Real-Time Supervision of Prehospital Point-of-Care Ultrasound: A Feasibility Study

Background: Although prehospital point-of-care ultrasound (POCUS) is gaining in importance, its rapid interpretation remains challenging in prehospital emergency situations. The technical development of remote real-time supervision potentially offers the possibility to support emergency medicine providers during prehospital emergency ultrasound. The aim of this study was to assess the feasibility of live data transmission and supervision of prehospital POCUS in an urban environment.Methods: Emergency doctors with moderate ultrasound experience performed prehospital POCUS in emergency cases (n=24) such as trauma, acute dyspnea or cardiac shock using the portable ultrasound device LumifyTM. The ultrasound examination was remotely transmitted to an emergency ultrasound expert in the clinic for real-time supervision via a secure video and audio connection. Technical feasibility as well as quality of communication and live stream were analysed.Results: Prehospital POCUS with remote real-time supervision was successfully performed in 17 patients (71%). In 3 cases, the expert was not available on time and in 1 case remote data transmission was not possible due to connection problems. In 3 cases tele-supervision was restricted to video only due to power saving mode of the tablet.Conclusion: Remote real-time supervision of prehospital POCUS is feasible most of the time with excellent image and communication quality. Trial registration: ClinicalTrials Number NCT04612816

Paediatric small-bowel intussusception on ultrasound – a case report with differentiating features from the ileocolic subtype

Aim of the study: Intussusception is a common paediatric emergency which can be diagnosed with relative certainty by ultrasonography in trained hands. Both the ileocolic and small-bowel intussusception have overlapping clinical features and imaging findings on ultrasound. The aim is to differentiate between both subtypes based on selective differentiating features which should always be looked for while performing an ultrasound examination in suspected cases. Differentiating between the two subtypes is essential, since patient management may differ depending on the subtype. Case description: We present a case of a 12-year-old boy who presented to our hospital with pain in the abdomen. An emergency ultrasound revealed findings suggestive of small- bowel intussusception. A brief description of the differentiating points from the ileocolic subtype is also described. Conclusions: Based on the features described, it is possible to confidently differentiate between the two subtypes, which is a guiding factor for treatment.

Can the ultrasound suggest the emergency operation of a sliding ovary in a hernia sac?

In this case, it is described the importance of ultrasound in children with sliding ovaries in inguinal hernias. If the child has no symptoms, an emergency ultrasound could suggest the manner of the operation, scheduled or emergency.