Staring this summer, Magen David Adom paramedics will be using ultrasound technology aboard the service’s Medevac helicopters and Mobile Intensive Care Unit Ambulances.
Initially, the ultrasound will be used primarily to view the hearts of patients in suspected cardiac arrest or deep shock and to help paramedics establish IV lines in patients with hard-to-detect veins.
“Even in patients where good veins are hard to find, we can see veins very clearly with the ultrasound,” said Dr. Shafir Botner, director of paramedic training for MDA.
“This is yet another step by Magen David Adom to bring technologies previously only available in emergency departments or clinical settings into our MICUs,” said MDA medical director Dr. Refael Strugo.
“Being able to actually see a patient’s heart function through an ultrasound probe, rather than merely observe the heart’s electrical impulses through an ECG, provides us with a clearer picture of his condition and enables us to make better informed and potentially lifesaving medical decisions,” Dr. Strugo said.
The use of ultrasound equipment is potentially a game-changer in treating a critical cardiac condition known as pseudo PEA (pulseless electrical activity) in which the patient has no palpable pulse, but an ultrasound reveals the presence of ventricular contractility, the semblance of a heartbeat.
“In these cases, rather than initiate electric shocks from a defibrillator or provide chest compressions, the protocol would be to administer fluids and adrenaline to raise the patient’s blood pressure, to promote more productive beats,” said Dr. Botner.
“Without the ultrasound equipment,” he added, “it’s nearly impossible to differentiate these cases from patients with true asystole, where the patient has truly flat-lined and where our response would be different.”
Recent studies have indicated that pseudo PEA, where there’s no palpable pulse, but actual heartbeats are occurring, is far more common than previously thought, and many patients would benefit from having the ultrasound aboard MDA’s vehicles.
Several hundred MDA paramedics have already been trained to use the new equipment. The rest of MDA’s 1,000 paramedics will be fully trained by the end of this year.
With additional training in the future, Dr. Botner added, MDA paramedics will also be using the ultrasound to detect other conditions, such as tension pneumothorax, in which the patient’s lungs leech air into the chest cavity, a potentially fatal condition that can block breathing.