Portable ultrasound machine

A new use for portable ultrasounds in emergency medicine

Medical student leads emergency medicine study in Central Texas to get diagnostic momentum in the right direction, sooner
September 1, 2017

Jason Bowman, MD, who was a paramedic for more than a decade before becoming a medical student at Texas A&M College of Medicine, started noticing a trend during his ambulance rides. As a paramedic, he saw how portable ultrasound use in ambulances were effective in diagnosing patients who had experienced trauma.

Ultrasound machines are very effective in helping to tell the difference between air and fluid within the human body, so they’ve been primarily utilized with trauma patients to detect internal bleeding as quickly as possible and help doctors at the emergency room create a course of treatment, sooner.

Bowman believes that they’re so effective in helping create a better course of treatment, sooner, that he’s pioneered a 90-day study to prove it. He recently finished the research portion of his study looking at this use of portable ultrasounds beyond trauma-specific emergency situations. His goal: Make portable ultrasound machines more useful for diagnosing patients on the way to the hospital, and help encourage EMS services to invest in the equipment.

“That time spent in an ambulance transporting a patient shouldn’t just be used for transportation,” Bowman said. “With ultrasound, providers can spend that time figuring out what’s actually going on with the patient and create a course of treatment sooner and ultimately improve the patient outcome.”

The new technology, which can be plugged into a portable tablet or smart phone, can be used to find areas of excess fluid in the body or locate veins. Training to use the device takes about four hours. Emergency medical service (EMS) personnel can also record the footage and share it with the emergency physicians upon arrival to the hospital.

Traditionally, ultrasound isn’t something paramedics really do, unless on very traumatic injuries—which doesn’t actually change the patient outcome very much. Many EMS aren’t even equipped with ultrasound machinery.

When responding to an emergency call for a sick patient, the patient may be short of breath, have low blood pressure, or could even be unconscious. The EMS may not have a clear idea of what’s going on.

“A great example of this was a patient who was picked up by EMS and was suspected of having pneumonia,” Bowman said. “Using an ultrasound on the way to the hospital, we found that they actually had a collapsed lung—which is a totally different treatment. Sometimes, you think you know exactly what’s wrong with them, and then you get some imaging and you realize you were completely wrong.”

Bowman, who was a fireman-paramedic before becoming a medical student, was inspired to conduct the study years ago when he worked in an area of Texas that had a lot of nursing homes, but not a lot of car wrecks, and he learned how to use ultrasounds for things other than trauma.

Bowman hopes that the research results, which are still being analyzed, will help support the use of ultrasound in ambulances across the country, and improve diagnostics for emergency patients.

While the results of the study are being analyzed, Bowman is headed to the University of Kentucky for his residency, where he will specialize in emergency medicine.

— Katherine Hancock

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