Telemedicine can be a feasible means of guiding untrained general practitioners to perform point-of-care ultrasound in life-threatening situations: the case of a field hospital during the COVID-19 pandemic

O ultrassom guiado por telemedicina realizado por clínicos gerais não treinados pode ser viável em uma situação de risco de vida: o caso de um hospital de campanha durante a pandemia de COVID-19

Abstract

Objective:

To evaluate the feasibility of telemedicine using a standardized multiorgan ultrasound assessment protocol to guide untrained on-site general practitioners at a field hospital during a life-threatening crisis.

Materials and Methods:

We evaluated 11 inpatients with shock, with or without acute dyspnea, for whom general practitioners spontaneously requested remote evaluation by a specialist.

Results:

All of the general practitioners accepted the protocol and were able to position the transducer correctly, thus obtaining key images of the internal jugular vein, lungs, and inferior vena cava when guided remotely by a telemedicine physician, who interpreted all of the findings. However, only four (36%) of the on-site general practitioners obtained the appropriate key image of the heart in the left parasternal long-axis view, and only three (27%) received an immediate interpretation of an image from the remote physician. The mean evaluation time was 22.7 ± 12 min (range, 7-42 min).

Conclusion:

Even in life-threatening situations, untrained general practitioners may be correctly guided by telemedicine specialists to perform multiorgan point-of-care ultrasound in order to improve bedside diagnostic evaluation.

Keywords:
Telemedicine; Point-of-care systems; Ultrasonography; Emergencies; Coronavirus infections