Use of point-of-care ultrasound (POCUS) in the diagnosis of abdominal trauma performed by a paramedic in EMS: a case report

Ambulance Service in Poland, in their daily work, are obliged to make appropriate diagnoses already at the prehospital level. Effective diagnostics is the key to proper diagnosis, treatment and decision-making by the emergency medical service (EMS) leader paramedic. In particular, the history and physical examination are the key to solving the mystery regarding the patient's health condition, predicting and avoiding death. Nevertheless, not every emergency presents, at the time of examination, suspicious symptoms that do not give any clear symptoms, and without using a specific imaging method at the scene of the incident, we limit the proper assessment of the patient's condition and future prognosis, which may be dramatic or even fatal, especially given the scant history the patient presents. We would like to present a case of the appropriateness of using ultrasound at the pre-hospital level, which turned out to be crucial for the management of the patient in accordance with medical art, even if he does not consent to transport to the hospital and no symptoms suggest that the current condition is a threat not only to health, but even to life. We would like to prove that a simple pre-hospital ultrasound scan can help make a very advanced diagnosis, complementing the patient's scant interview and pointing to the circumstances that occurred at the scene of the incident. After losing consciousness, a young woman with an accidental abdominal injury, without typical symptoms, was correctly diagnosed by a paramedic, which allowed for the diagnosis of a life-threatening condition at the scene of the incident.