Point of care prehospital ultrasound in Basic Emergency Services in Portugal

Manuel José Cruz Duarte Lobo; Sérgio Carlos Castanheira Nunes Miravent Tavares; Rui Pedro Pereira de Almeida

doi:10.1002/hsr2.847

Point of care prehospital ultrasound in Basic Emergency Services in Portugal

Health Sci Rep. 2022 Sep 20;5(5):e847. doi: 10.1002/hsr2.847. eCollection 2022 Sep.

Authors

Manuel José Cruz Duarte Lobo¹, Sérgio Carlos Castanheira Nunes Miravent Tavares², Rui Pedro Pereira de Almeida³

Affiliations

¹ Local Health Unit of the Northeast (ULSNE), International Society of Clinical Ultrasound (SIEC), Medical Imaging and Radiotherapy Portuguese Association (APIMR), International Society of Radiographers and Radiological Technologists (ISRRT) Bragança Portugal.
² Basic Emergency Service Vila Real de Santo António Portugal.
³ Medical Imaging and Radiotherapy Department, Center for Studies and Development in Health (CES) University of Algarve, Portugal, CHCR - Compreensive Health Research Center, Évora - Portugal. APIMR (Medical Imaging and Radiotherapy Portuguese Assciation) Faro Portugal.

Abstract

Background and aims: The Point of Care Ultrasound and Point-of-Care Ultrasound in Resource-Limited Settings are differentiated diagnostic methods using ultrasound, essential in urgent patients screening, allowing better guidance in the diagnostic process and therapeutic approach. This study intends to observe the impact of these techniques in two Basic Emergency Services (SUB) in Portugal.

Methods: A longitudinal study was carried out in two remote locations in Portugal (SUB N and SUB S). Data were collected by trained radiographers in each location, and a total of 972 exams were considered. Imaging findings were documented by exam type, the exam normality and the resolution after exam. χ ² and Cramer's V tests were performed to check significant correlations between the variables.

Results: Regarding the type of echographic findings, 289 (29.7%) were considered normal, 628 (64.6%) were classified as abnormal and 55 (5.7%) were considered inconclusive. As for the type of resolution, 58% had local resolution, 24% were referred to a hospital emergency service and 18% referred to ambulatory care. Regarding the Location versus Resolution after exam versus Findings variables, it was verified a stronger statistically significant association for the exams considered "Abnormal" (Cramer's V = 0.414; p < 0.001). In the variables Location versus Findings versus Resolution after exam, it was verified a stronger statistical significance for "Referral to Ambulatory" (Cramer V = 0.443; p < 0.001) although Referral for Hospital (Cramer V = 0.252; p = 0.003) or Local Resolution (Cramer V = 0.252; p < 0.001) also had a moderate association strength.

Conclusion: Ultrasonography is a useful diagnostic tool for patients screening, having an influence on patient management in remote settings. Given the limited literature in Portugal about this matter, further research and literature will be needed to support and complement the results of this study.

Keywords: POCUS; PURLS; Portugal; Radiographer; Remote; Ultrasound.