SWOT analysis of prehospital ultrasound use and its practical implications

This study aimed to assess the strengths, weaknesses, opportunities, and threats (SWOT) associated with prehospital ultrasound (US) use by paramedics and to explore its practical implications in emergency medical services. A structured, semiquantitative approach was employed, involving literature screening from 4 databases (PubMed, Scopus, Web of Science, and Medline) and synthesis via thematic content analysis, semiotic coding, and SWOT framework. Studies focusing on field use of US by paramedics were included. Predefined thematic indicators were applied to classify data into SWOT domains, and frequency analysis was used to identify prevailing patterns and trends. Among strengths, early diagnosis was most frequently reported (62.5%), followed by accurate intervention (25.0%) and diagnostic-guided treatment planning (12.5%). Weaknesses included limited training and experience (58.33%) and technical/device constraints (25.0%). Opportunities centered around digital education (54.17%) and emerging portable technologies (25.0%). Misdiagnosis (45.83%) and incomplete interventions (37.5%) were noted as key threats. Prehospital US performed by trained paramedics shows clear strengths in enabling early diagnosis and time-critical decision-making, but its scale-up is limited by insufficient longitudinal training/exposure and the absence of standardized implementation protocols. Opportunities include blended/digital education, tele-US supervision, and robust quality assurance and image archiving; the principal threat is misdiagnosis under real-world operational constraints, with downstream risks for triage and interventions. These findings support implementing structured, condition-specific longitudinal training, service-wide protocols with defined roles and maintenance accountability, and standardized equipment - priorities that future multicenter studies should link to patient-oriented outcomes.