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Coda Change

Dec 12, 2018

Luke Regan presents the emerging evidence for prehospital ultrasound and telehealth in his talk from the SMACC stage. Luke has a personal interest in improving prehospital care. He lives in the north of Scotland. It is an austere and challenging environment, far from technology. Compounding this, it is underserviced and there is an absence of critical care with no critical in reach. Unfortunately, the morbidity and mortality of the area does not match the spread of care. Therefore, it is one of the motivations for his research. That being said, he is not alone in his desire for this research. Pre-hospital ultrasound topped the list of technology-based research priorities in pre-hospital critical care, as determined by a European research collaboration. This is in large part because much of what is done in pre-hospital care still exists in an evidence free zone. Luke discusses the extended pre-hospital patient journey in his practice. This presents a challenge, but also an opportunity. If time zero is further back, testing a pre-hospital intervention becomes very achievable. There is precedent for this. Benefit of pre-hospital interventions have been highlighted by the relative benefit of stopping and performing roadside ECG in transit. This has allowed road crews to receive updated treatment advice based on that ECG. This bundle of care is similar to what is possible with pre-hospital ultrasound. Currently, there is a very apparent practice creep when it comes to the use of ultrasound. This means there is an increase in the use of pre-hospital ultrasound around the world. However, it remains an evidence poor area. Luke describes two studies conducted in Scotland looking to answer the big questions in pre-hospital point of care ultrasound (POCUS). Firstly, can it make a difference? Secondly, does it take too long? Finally, who should do it and how long does it take to train them? This is done in large studies, with lots of patients and inputs from a diverse meeting of minds. Join Luke Regan as he discusses the evidence behind the application of pre-hospital ultrasound and telemedicine.

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