Use of Ultrasound in the Prehospital Setting: A Scoping Review

Abstract

Objectives: With the advent of portable devices, prehospital ultrasound is increasingly available and has the potential to provide clinical and procedural decision support. This scoping review seeks to examine current literature on prehospital ultrasound, including study indications, the level of the health care professionals performing prehospital ultrasound, and reported research outcomes.

Methods: We searched PubMed, Embase, Web of Science, CINAHL, and Cochrane databases for research articles and conference abstracts focused on prehospital ultrasound with scans performed in the field. After title/abstract screening by 2 independent reviewers, a full-text review was performed. We excluded reviews, case reports, letters to the editor, and research published in nonEnglish language. Descriptive statistics were reported.

Results: We identified 9718 unique articles, and 109 were included after title/abstract review (Kappa 0.68) and full-text analysis. Annual publications increased yearly (P < .01). Nineteen countries were represented, with the United States having the highest number of publications (n = 34, 31.2%). Most studies were prospective (n = 74, 67.9%) with few randomized control trials (n = 6, 5.5%). Feasibility studies comprised 45.9% (n = 50) of the included publications, while clinical outcomes were the primary interest in 18 studies (16.5%). Physicians (n = 58, 53.2%) and paramedics (n = 38, 34.9%) were the most studied prehospital clinicians. The most common indication was trauma (n = 49, 45%) followed by dyspnea (n = 13, 11.9%) and cardiac emergencies (n = 10, 9.2%).

Conclusion: There is a growing, heterogeneous body of literature describing the use of prehospital ultrasound. Published literature was primarily prospective and described feasibility trials. Identified gaps include a lack of studies in pediatric patients and research identifying clinical outcomes.