Point-of-care ultrasound (POCUS) use in mountain emergency medicine: results from an international online survey

Background Point-of-care ultrasound (POCUS) is increasingly used prehospitally for both diagnostic and procedural applications. In urban settings, there is evidence that prehospital POCUS correlates well with in-hospital diagnostic results and can improve the treatment of patients without significantly prolonging time on-site. The extent to which POCUS is currently being used in international mountain emergency medicine has not yet been investigated. The aim of this study was to determine the current use of POCUS in mountain rescue organizations which are members of the International Commission for Alpine Rescue (ICAR). Methods We asked ICAR members to complete an online survey on their current use of POCUS during mountain rescue operations. The survey gathered information about staffing, ultrasound equipment, indications, perceived utility, and aspects of education and clinical supervision. Results Twelve of 39 included rescue organizations used POCUS when providing patient care in the field (31%, n = 12). POCUS was primarily available in organizations, which provide helicopter emergency medical services (HEMS), with or without additional terrestrial rescue services. Most rescue organizations used POCUS occasionally (64%, n = 7), depending on the provider, the type of rescue, and the encountered medical problem. POCUS was considered equally relevant in both medical and traumatic emergencies. Most providers considered that POCUS changed the treatment of their patients in the field (67%, n = 8). Half of the providers used standardized ultrasound protocols (50%, n = 6). Half of the rescue organizations did not record POCUS findings (50%, n = 6). Most rescue organizations did not have a framework in place for education and clinical supervision (91%, n = 10). Conclusions Our survey shows that POCUS currently plays a substantial role in international mountain emergency medicine. POCUS is primarily used during helicopter-based rescue but is also available in some organizations who provide terrestrial rescue. Most rescue providers use POCUS in select patient groups presenting with specific clinical conditions. The availability of POCUS during mountain rescue operations seems to influence on-site clinical decision-making. Although POCUS providers often use standardized protocols when performing examinations, aspects of education and clinical supervision will need to be addressed in the future.