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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
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

Rural Pre Hospital Ultrasound

Improving the System

welcome to winnemucca nevada
Welcome to Winnemucca, Nevada

Humboldt General Hospital EMS Rescue

10 000 square mile service area
10,000+ Square Mile Service Area

Humboldt General Hospital EMS Rescue

very remote trauma
Very Remote Trauma

Humboldt General Hospital EMS Rescue

it s 12 15 a m
It’s 12:15 a.m. . .

Humboldt General Hospital EMS Rescue

pre hospital ultrasound

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

the wall street journal

“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

better patient outcomes yes
Better patient outcomes? YES!

Humboldt General Hospital EMS Rescue

proactive vs reactive medicine
Proactive vs. reactive medicine

Humboldt General Hospital EMS Rescue

ultrasound s capabilities

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

benefits trauma

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

benefits trauma14
Benefits: Trauma

Humboldt General Hospital

benefits cardiology

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

benefits obstetrics

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

buy in

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

education

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

continuing education

50 Scans per year for competency and proficiency

  • Continuous quality assurance
Continuing Education

Humboldt General Hospital

exams we can provide

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

improving the efficacy of our pre hospital ems system

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

what needs to change

Acceptance of practice

  • Physician buy-in
  • Reimbursement structure
What needs to change

Humboldt General Hospital EMS Rescue

future

Standard of care

  • Transmission of the Ultrasound
  • MCI use
  • Paramedicine use
  • Increasing diagnostic uses
Future

Humboldt General Hospital EMS Rescue