UMEM Educational Pearls

Title: Lung Ultrasound for CHF in the Prehospital Setting

Category: Ultrasound

Keywords: POCUS, Lung ultrasound, EMS (PubMed Search)

Posted: 12/2/2024 by Alexis Salerno, MD (Updated: 12/22/2024)
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Early treatment of congestive heart failure (CHF) exacerbations is associated with improved mortality rates and shorter hospital length of stay. Lung ultrasound is a valuable tool in diagnosing CHF exacerbations. Recently, several studies have explored the use of lung ultrasound in the prehospital settings to expedite diagnosis and treatment. 

A recent systematic review and meta-analysis evaluated the diagnostic accuracy and clinical impact of prehospital lung ultrasound. The authors found similar test characteristics to point-of-care ultrasound (POCUS) performed in the emergency department. 

The eight studies included in the analysis utilized varying lung ultrasound protocols, analyzing between 2 and 8 lung zones. Notably, only two studies involved paramedics performing the ultrasounds, yet no significant difference in diagnostic accuracy was observed. 

Further research is needed to evaluate the training requirements for prehospital providers and the broader impact of prehospital lung ultrasound on treatment strategies and patient outcomes.

References

  1. Russell FM, Harrison NE, Hobson O, Montelauro N, Vetter CJ, Brenner D, Kennedy S, Hunter BR. Diagnostic accuracy of prehospital lung ultrasound for acute decompensated heart failure: A systematic review and Meta-analysis. Am J Emerg Med. 2024 Jun;80:91-98. doi: 10.1016/j.ajem.2024.03.021
  2. Russell FM, Supples M, Tamhankar O, Liao M, Finnegan P. Prehospital lung ultrasound in acute heart failure: Impact on diagnosis and treatment. Acad Emerg Med. 2024 Jan;31(1):42-48. doi: 10.1111/acem.14811