Research on diagnostics

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blindsideflank

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Hey, I'm looking for research on diagnostics such as ECG/istat/troponin/ultrasound for EMS. I am looking to explore how these things are studied.

Feasability-can paramedics learn to do this?
Cost-is it worth it?
Pt outcomes-does it change anything, transport decisions? Treatment decisions!
How are these tested?

When I think of having the istat on car, it's confusing how to prove it is useful, but it is obvious to me it opens up possibilities to new treatments/protocols. This cant really be proven in a study though.


I'm just brainstorming and trying to learn more about the processes/protocols used for the research on these things. And which needs to come first. (feasability would be first I think)

Let's start a discussion and see where this goes (this is not for school but maybe it could lead there one day)
 
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Ask each time:
1. Is it feasible in the time between arrival and getting to defintive care?
2. Is it robust enough, small enough and energy efficient enough to take on the road?
3. Consider "The Dilemma of the Dog and the Semi": You caught it, now what will you do (with this data)?
 
n7lxi said:
There have been studies on all of these things.

Have you done a PubMed search?

Troponin: http://www.sciencedirect.com/science/article/pii/S0002914911003006

FAST:
http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2010.00755.x/full

http://www.springerlink.com/index/U614WN513T9404Q6.pdf

I could go on for days...
Click to expand...


"Prehospital ultrasound has the potential to improve patient outcomes by improving time to diagnosis and early delivery of critically ill patients who are amenable to time-dependent lifesaving interventions. It also has the promising ability to assist in making appropriate destination decisions for the patient. Our study shows that paramedics can perform the FAST and abdominal aortic ultrasound exams in the prehospital environment with a high degree of accuracy."
This study shows medics can do the skill, I would call it a feasability study

"Further prospective outcome studies are needed" this review is similar, the skill can be done


"A diagnosis of AMI was established in 208 of 258 patients with increased TnT. "The prehospital test identified 30% of these patients, whereas the first in-hospital test detected 79%. Median times from symptom onset to blood sampling were 83 minutes (46 to 167) for the prehospital sample and 165 minutes (110 to 276) for the admission sample"
I like this because it shows possible improved pt outcomes


Thanks, this was a great start. I was already familiar with the 2 ultrasound studies because I am particularly interested in this.
 
I think I'm asking about knowledge translation as well. How do you show this should/shouldn't be on ambulance
 
Also with iStat you might want to look at if you believe that the organization will be able keep up with the point of care testing quality controls. iStat isn't difficult overall, but thinking about the procedures and protocols needed before may be good.
 
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