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

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.

摘要 研究目的：评估在致命危机场景下，采用标准化多器官超声评估方案，指导野战医院内未接受过相关培训的现场全科医师开展远程医疗的可行性。材料与方法：本研究纳入11例合并或不合并急性呼吸困难的休克住院患者，由现场全科医师主动提出申请，请求专科医师进行远程评估。结果：所有全科医师均接受该方案，并在远程医疗专科医师的指导下正确摆放超声探头，成功获取颈内静脉、肺部及下腔静脉的关键图像，由该远程医师完成所有影像结果判读。但仅4名（36%）现场全科医师获取了符合要求的胸骨旁左心室长轴切面心脏关键图像，且仅3名（27%）获得了远程医师即时出具的影像判读结果。平均评估时长为22.7±12分钟（范围：7~42分钟）。结论：即便处于致命危机场景中，未接受过相关培训的全科医师仍可在远程医疗专科医师的正确指导下完成多器官床旁超声检查，从而提升床旁诊断评估能力。