Prehospital Standards for Point of Care Ultrasound A Brief National Review

Main Article Content

Dilpreet Bajwa, BHSc
Jared Price, BSc
Savanna Boutin, MD, BHSc
Ankit Kapur, MB, BSc, BAO, BCh

Abstract

Point of care ultrasound (POCUS) has become an increasingly recognized tool for the rapid bedside assessment of undifferentiated patients. With the advent of affordable portable devices, this tool has expanded to the prehospital world, offering an opportunity to improve patient care prior to arrival in the emergency department. To assess how this tool has become incorporated into paramedical care in Canada, we conducted a cross-sectional survey of paramedical licensing bodies across Canada investigating POCUS accreditation, licensing, scope of practice, and quality assurance regulation for paramedics. Overall, few provincial paramedical licensing bodies include POCUS in the scope of practice for prehospital practitioners, and those who do are not involved with POCUS training, licensing, or quality assurance. Our findings highlight the need for defined competence standards and quality assurance metrics to ensure safe and effective use of this bedside tool.

Article Details

How to Cite
Bajwa, D., Price, J., Boutin, S., & Kapur, A. (2024). Prehospital Standards for Point of Care Ultrasound: A Brief National Review. International Journal of Paramedicine, (5), 28–33. https://doi.org/10.56068/NXKY6705
Section
Reviews

References

Amaral, C. B., Ralston, D. C., & Becker, T. K. (2020). Prehospital point-of-care ultrasound: A transformative technology. SAGE Open Medicine, 8, 205031212093270. https://doi.org/10.1177/2050312120932706

Becker, T. K., Martin-Gill, C., Callaway, C. W., Guyette, F. X., & Schott, C. (2018). Feasibility of Paramedic Performed Prehospital Lung Ultrasound in Medical Patients with Respiratory Distress. Prehospital Emergency Care, 22(2), 175–179. https://doi.org/10.1080/10903127.2017.1358783

Bøtker, M. T., Jacobsen, L., Rudolph, S. S., & Knudsen, L. (2018). The role of point of care ultrasound in prehospital critical care: A systematic review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26(1). https://doi.org/10.1186/s13049-018-0518-x

Canadian Organization of Paramedics. (2021). COPR to Develop Pan-Canadian Essential Regulatory Requirements for Paramedics July.

Chawla, T. P., Cresswell, M., Dhillon, S., Greer, M. L. C., Hartery, A., Keough, V., & Patlas, M. N. (2019). Canadian Association of Radiologists Position Statement on Point-of-Care Ultrasound. Canadian Association of Radiologists Journal, 70(3), 219–225. https://doi.org/10.1016/j.carj.2019.06.001

Donovan, J. K., Burton, S. O., Jones, S. L., & Meadley, B. N. (2022). Use of Point-of-Care Ultrasound by Non-Physicians to Assess Respiratory Distress in the Out-of-Hospital Environment: A Scoping Review. Prehospital and Disaster Medicine, May, 1–9. https://doi.org/10.1017/s1049023x22000711

Hermann, M., Hafner, C., Scharner, V., Hribersek, M., Maleczek, M., Schmid, A., Schaden, E., Willschke, H., & Hamp, T. (2022). Remote real-time supervision of prehospital point-of-care ultrasound: a feasibility study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 30(1), 1–7. https://doi.org/10.1186/s13049-021-00985-0

Laursen, C. B., Hänselmann, A., Posth, S., Mikkelsen, S., Videbæk, L., & Berg, H. (2016). Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: A pilot study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 24(1), 1–8. https://doi.org/10.1186/s13049-016-0288-2

Leschyna, M., Hatam, E., Britton, S., Myslik, F., Thompson, D., Sedran, R., VanAarsen, K., & Detombe, S. (2019). Current State of Point-of-care Ultrasound Usage in Canadian Emergency Departments. Cureus. https://doi.org/10.7759/cureus.4246

Lewis, D., Rang, L., Kim, D., Robichaud, L., Kwan, C., Pham, C., Shefrin, A., Ritcey, B., Atkinson, P., Woo, M., Jelic, T., Dallaire, G., Henneberry, R., Turner, J., Andani, R., Demsey, R., & Olszynski, P. (2019). Recommendations for the use of point-of-care ultrasound (POCUS) by emergency physicians in Canada. CJEM, 21(6), 721–726. https://doi.org/10.1017/cem.2019.392

Nadim, G., Laursen, C. B., Pietersen, P. I., Wittrock, D., Sørensen, M. K., Nielsen, L. B., Rasmussen, C. H., Christensen, H. M., Helmerik, S., Jørgensen, G., Titlestad, I. L., Lassen, A. T., & Mikkelsen, S. (2021). Prehospital emergency medical technicians can perform ultrasonography and blood analysis in prehospital evaluation of patients with chronic obstructive pulmonary disease: a feasibility study. BMC Health Services Research, 21(1), 1–12. https://doi.org/10.1186/s12913-021-06305-7

Naeem, S., Edmunds, C., Hirst, T., Williams, J., Alzarrad, A., Ronaldson, J., Barratt, J., Research, Audit, Innovation and Development Group, E. A. A. A., & Research Network, P. T. O. (2022). A National Survey of Prehospital Care Services of United Kingdom for Use, Governance and Perception of Prehospital Point of Care Ultrasound. POCUS Journal, 7(2), 232–238. https://doi.org/10.24908/pocus.v7i2.15739

Paramedic Association of Canada. (2011). National Occupational Competency Profile For Paramedics.

Pietersen, P. I., Mikkelsen, S., Lassen, A. T., Helmerik, S., Jørgensen, G., Nadim, G., Christensen, H. M., Wittrock, D., & Laursen, C. B. (2021). Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1), 1–9. https://doi.org/10.1186/s13049-021-00856-8

Schoeneck, J. H., Coughlin, R. F., Baloescu, C., Cone, D. C., Liu, R. B., Kalam, S., Medoro, A. K., Medoro, I., Joseph, D., Burns, K., Bohrer-Clancy, J. I., & Moore, C. L. (2021). Paramedic-performed prehospital point-of-care ultrasound for patients with undifferentiated dyspnea: A pilot study. Western Journal of Emergency Medicine, 22(3), 750–755. https://doi.org/10.5811/westjem.2020.12.49254

Smallwood, N., & Dachsel, M. (2018). Point-of-care ultrasound (POCUS): Unnecessary gadgetry or evidence-based medicine? Clinical Medicine, Journal of the Royal College of Physicians of London, 18(3), 219–224. https://doi.org/10.7861/clinmedicine.18-3-219