dr-exmedic.com

The July issue of EMS Magazine has a nice little article about prehospital ultrasound, hysterically captioned by a shot of a German fire department physician scanning a patient.  While the article was basically cautiously optimistic, there was one double-barrel caveat slipped in at the end of one paragraph:

The utility of this information will depend on the transport time as well as the training level of the provider in the ambulance or helicopter.

I have to agree with both.  I could see a rural department using FAST exams to cut down on the number of patients they fly to trauma centers, or maybe getting more aggressive with pneumothorax treatment if they used ultrasound to diagnose those.  There seems to be less call for additional data in the sort of setting where you’re 15 minutes from the nearest tertiary care center.

By the same token, we have a long way to go with respect to the education of providers (at least in most states).  Docs doing their own ultrasounds have gone to medical school, obviously, with literally months of education in anatomy and a year of college physics behind them.  To sit for the RDMS (Registered Diagnostic Medical Sonographer) exam takes 2 years of physics, anatomy, and observed ultrasound practice.  While we probably don’t need to go that far if we’re teaching medics a somewhat more limited ultrasound practice, there definitely has to be a bit more education than throwing ultrasounds at them in an 8-hour FAST exam course.