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2010 Rural and Frontier EMS and Trauma Summit at the Divide

2010 Rural and Frontier EMS and Trauma Summit at the Divide. Pat Songer, NREMT-P, ASM Director of Emergency Medical Services – Humboldt General Hospital. Rural Pre Hospital Ultrasound. Improving the System. Welcome to Winnemucca, Nevada. 10,000+ Square Mile Service Area . Very Remote Trauma.

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2010 Rural and Frontier EMS and Trauma Summit at the Divide

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  1. 2010 Rural and Frontier EMS and Trauma Summit at the Divide Pat Songer, NREMT-P, ASM Director of Emergency Medical Services – Humboldt General Hospital

  2. Rural Pre Hospital Ultrasound Improving the System

  3. Welcome to Winnemucca, Nevada Humboldt General Hospital EMS Rescue

  4. 10,000+ Square Mile Service Area Humboldt General Hospital EMS Rescue

  5. Humboldt General Hospital EMS Rescue

  6. Very Remote Trauma Humboldt General Hospital EMS Rescue

  7. It’s 12:15 a.m. . . Humboldt General Hospital EMS Rescue

  8. First utilized in the U.S. around 2003 • A non-invasive look into a patient, no more guessing what is going on • The F.A.S.T. exam was the tip of the iceberg Pre Hospital Ultrasound Humboldt General Hospital

  9. “At least two hospitals are training staff to use the Siemens Acuson P10 and plan to publish papers on the results. Pamela Wickkiser, radiology director at Humboldt General Hospital in Winnemucca, Nev., has paramedics using the devices in ambulances . . . "They are actually picking the skills up pretty well," she says. "For us, being so rural out here, it would be a big plus to get this kind of information pre-hospital.”—February 2010 The Wall Street Journal? Humboldt General Hospital EMS Rescue

  10. Better patient outcomes? YES! Humboldt General Hospital EMS Rescue

  11. Proactive vs. reactive medicine Humboldt General Hospital EMS Rescue

  12. Portable (about 1.6 lbs; fits in a lab coat pocket) • Designed for ease of use with an intuitive PDA-style user interface • Ready anywhere, anytime with instant power-up (~ 5-second) • High-quality images (fundamental and harmonic 2D-mode) • Industry-standard USB port for information sharing, upgrades Ultrasound’s Capabilities Humboldt General Hospital EMS Rescue

  13. FAST • Instantly gain insight into critically injured patients • Instantly visualize cardiac activity during resuscitation or “crash” events • Reduce or eliminate unnecessary procedures or treatments • Improves bedside monitoring • Improves outcomes Benefits: Trauma Humboldt General Hospital EMS Rescue

  14. Benefits: Trauma Humboldt General Hospital

  15. Easily evaluate patients who do not fall into traditional risk groups • Reduce or eliminate unnecessary procedures or treatments • Enable patients to view exam results at the point of care • Improve bedside monitoring Benefits: Cardiology Humboldt General Hospital EMS Rescue

  16. Evaluate fetal presentation, heartbeat, and general well-being, fluid levels, and placenta location • Obtain more information to assess unexplained bleeding, pelvic pain, or other symptoms • Enable patients to view exam results at the point of care • Improve bedside monitoring • Helps with patient fears Benefits: Obstetrics Humboldt General Hospital EMS Rescue

  17. Efficacy of patient outcomes • Portable, multi-departmental use • Ability to forego “worst-case” medicine • Ability to decrease door to surgery times • Hospital Staff Buy-in Humboldt General Hospital EMS Rescue

  18. Basic 20-hour course • FAST Exam Course • 2 day use course with On-sight and UC Davis • Pre-Hospital personnel efficacy exams Education Humboldt General Hospital EMS Rescue

  19. 50 Scans per year for competency and proficiency • Continuous quality assurance Continuing Education Humboldt General Hospital

  20. Central and Venous Line placement • ET Tube Placement • Confirmation of death • Pneumothorax/Hemopneumothorax • Pericardiocentesis guide • Differential diagnosis-CHF/COPD • Obstetrics • FAST • AAA Exams we can provide Humboldt General Hospital EMS Rescue

  21. Early diagnosis is an important aspect in providing immediate interventions. • Evidence-based treatments • Standard of care • Confirmation of Death • Reducing the “System” time Improving the efficacy of our pre-hospital EMS system Humboldt General Hospital EMS Rescue

  22. Acceptance of practice • Physician buy-in • Reimbursement structure What needs to change Humboldt General Hospital EMS Rescue

  23. Standard of care • Transmission of the Ultrasound • MCI use • Paramedicine use • Increasing diagnostic uses Future Humboldt General Hospital EMS Rescue

  24. Thank you…Questions

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