Evaluating the Use of Prehospital Lung Ultrasound in EMS: A Multicenter Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 1,000
- 试验地点
- 2
- 主要终点
- Percent of prehospital diagnoses agreeing with hospital diagnosis
研究概览
简要总结
The goal of this prospective nonrandomized study is to determine if prehospital lung ultrasound findings result in a change in patient management. This study will look at how lung ultrasound exam improves diagnosis of respiratory distress in patients being treated by Emergency Medical Services, such as patients with heart failure. Additional questions include:
- How well can paramedics obtain and interpret ultrasound images?
- How does ultrasound use change treatment received by patients?
- How does ultrasound use impact patient outcomes? Participants will receive a lung ultrasound exam, but otherwise receive standard evaluation and care. Patients who receive ultrasound will be compared to those who did not receive ultrasound for logistical reasons and patients from before the use of ultrasound. Ultrasound will not be withheld from any patient for the purposes of the study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient treated by Emergency Medical Services
- •Complaint of dyspnea
- •At least one of the following:
- •Oxygen saturation <94% on room air
- •Abnormal lung sounds
- •Increased work of breathing
- •Pedal edema
- •Orthopnea
排除标准
- •Pediatric patients (<18)
- •Traumatic etiology
- •Cardiac arrest at any point prehospitally
- •No ultrasound-trained paramedic involved in patient's care
研究组 & 干预措施
Patients before ultrasound implementation
Patients who meet inclusion criteria but were treated before ultrasound was available
Patients who receive ultrasound
干预措施: Pulmonary ultrasound (Diagnostic Test)
Patients who do not receive ultrasound
Patients who do not receive ultrasound after paramedic training due to factors such as lack of probe availability, clinician decision, refusal, etc. Ultrasound will not be deliberately withheld from any patient.
结局指标
主要结局
Percent of prehospital diagnoses agreeing with hospital diagnosis
时间窗: At time of hospital discharge (anticipated average of one week)
Diagnostic accuracy
Frequency with which prehospital lung ultrasound findings result in a change in patient management by EMS
时间窗: From time of patient encounter to patient handoff at the hospital. (anticipated average of one hour)
Frequency of management changes will be compared from before prehospital ultrasound was used to after prehospital ultrasound has been implemented.
次要结局
- Survival to discharge(At time of hospital discharge (anticipated average one week))
- Whether or not patient is intubated by EMS or during hospital admission, recorded as yes or no(EMS patient encounter to hospital discharge (anticipated average one week))
- Days on ventilator or non-invasive ventilation(Hospital arrival to hospital discharge (anticipated average one week))
- Length of stay(Hospital arrival to hospital discharge (anticipated average one week))
- Length of ICU stay(Hospital admission to hospital discharge (anticipated average one week))
- Paramedic ultrasound interpretation accuracy(Enrollment)
- Quality of ultrasound obtained by paramedic(Enrollment)
- Percent of prehospital diagnoses agreeing with hospital diagnosis(At time of hospital discharge (anticipated average of one week))
研究者
Tung-Lin Jesse Yuan, DO
Assistant Professor of Emergency Medicine
Rutgers, The State University of New Jersey