My adventure into the world of ultrasound started when I began working in the emergency department and saw how it was used as a point of care (POC) tool for central lines. As time went on, we started to get new doctors that were trained in ultrasound for anything and everything. So I started dabbling and asking questions, which led to studying and deeper inquiry until Jason Boitnott came back from SMACC with his next adventure… EMSPOCUS (since he lost his favorite thing to do–terrorize the RT department). As he explained the concept and goals of ultrasound in the field I decided to take the final plunge head first into the world of hands on training.
My plunge landed me in a seat surrounded by a large number of med students at the Colorado Ultrafest (@Ultrafest_CO). Ultrafest is mini conference led by some of the brightest minds in ultrasound and directed towards educating med student about the wonders of ultrasound. Thankfully they were kind enough to let a little ol’ paramedic like me tag along. The day started with the keynote speakers, Nikita Joshi (@njoshi8) and Creagh Boulger (@CreaghB). Nikita spoke on the power of social media and FOAMed. There were lots of shout outs to some of my personal favorite FOAMers and a good reminder that while FOAMed is powerful, we should research as well to confirm accuracy. Creagh spoke on the relevance of POCUS, why it should be taught and how her program integrates it into their curriculum.
After the lectures it was on to the fun stuff: probes, jelly and willing victims– I mean volunteers– to practice on. There were seven stations of which you could choose five to attend. I decided on the ones that I felt would transfer into the EMSPOCUS world and will touch on just a couple here. I chose FAST exam, pulmonary, vascular access, normal abdominal and cardiac. All of these exams were easy to learn and could easily transfer into the EMS world.
Imagine if you had a positive FAST in the field and how much quicker the patient could get to the OR. Or, we have all had that patient at 3am with low blood sugar on dialysis and are trying to push D50 through a 22 in the foot. But with ultrasound we can find a deeper vein in the arm, confirm it is in and easily push D50 with out praying to the vein gods that it won’t blow. With pulmonary ultrasound you can see the pneumothorax verses trying to hear it in the back of an emergent ambulance or helicopter. Also you can distinguish if it is a pneumothorax or hemothorax to determine chest tube orientation. Lastly there is the ability to ultrasound the heart –and what an amazing benefit this would have for EMS. I believe cardiac ultrasound in cardiac arrests could save a lot of dangerous transports by simply seeing if there is any cardiac activity. If there is none, a provider can call med control for a pronouncement (if required in their system) and not risk their crew’s or the public’s safety with an unnecessary emergent transport.
All in all, ultrasound is a great tool and something that will eventually make it to the field. I encourage you to learn what you can about it and Ultrafests are a great way of doing that. They are held around the country and are an amazing learning opportunity. Stay safe out there!
Chuck Hodges (@medichodgie)- Chuck decided to get into EMS when he found out the culinary school was going to cost $30,000 a year and an EMT cert was much, much less. After that class he was bitten be the EMS bug and charged forth ever since. His career has taken him from 911 systems to the ED to where he now serves as a Flight Paramedic in beautiful Colorado. In his free time he loves to cook and hang out with his family.