Guiding Emergency Treatment With Extended Focused Assessment With Sonography in Trauma by Emergency Responders (GET...

Area of Science:

• Emergency Medicine
• Point-of-Care Ultrasound
• Trauma Care

Background:

• Prehospital medicine faces challenges managing critically ill patients without hospital resources.
• Point-of-care ultrasound (POCUS) offers potential to bridge this gap by providing critical insights in trauma patients.

Purpose of the Study:

• To determine if early positive extended focused assessment with sonography in trauma (eFAST) identification by paramedics improves patient outcomes.
• To assess the feasibility and accuracy of paramedic-performed eFAST examinations.

Main Methods:

• Prospective observational trial conducted from February 2019 to August 2021.
• Paramedics with no prior ultrasound experience received training in eFAST examinations.
• 502 eFAST examinations were performed and analyzed for accuracy and impact on patient outcomes.

Main Results:

• Thirty-seven paramedics achieved a high correct interpretation rate (97.35%) for eFAST examinations.
• Sensitivity ranged from 30.0% to 75.0%, and specificity from 94.05% to 98.75%.
• On-scene time for eFAST and non-eFAST calls was not significantly different (P = .051).

Conclusions:

• Successful training and interpretation of eFAST by paramedics were demonstrated.
• The study did not find improved patient outcomes, likely due to low disease prevalence.
• High likelihood ratios suggest eFAST may be valuable for appropriate trauma resource utilization.