Pilot study in Frankfurt/Main
From 10/2001 to 5/2002 a prospective study on the use of preclinical sonography took place in Frankfurt / Main.

It was first asked to what extent the pre-clinical sonography a practical method for abdominal bleeding at the scene of an accident or a Hämatothorax to diagnose and the new pre-clinical diagnosis influence the management of severely injured patients. The sonography was not participating in an emergency care involved person applied.The doctors and the rescue team were informed of the outcome of the ultrasound and informed of the consequences of the additional diagnostic interviews.

During the admission of the patients in the shock room, the preclinical ultrasound findings have been  reaffirmed, by an additional  ultrasound examination (with the help of a renewed investigation with an ultrasound examination) respectively a computed tomography of the abdomen within the schock room diagnostic.

On 59 of the 61 patients were examined at an average treatment time of the accident at 21 ± 10 min, the sonographic examination in an average of 2.8 ± 1.2 minutes to be carried out. The preclinical sonography had a head start before the first ultrasound in the shock room of 20.3 ± 8.6 minutes.In 16 patients (26.2%) were free fluid diagnosed.The study showed a specificity of 97.5% and a sensitivity of 100%. In 36% of the pre-clinical operations management was modified.

Basically, additional large bore inflows have been laid, volume replacement given (differentiated administered volume replacement therapy) and the preclinical period shortened in the sense of a

"load and go”.

In 21% was due to the sonographic diagnosis on-site the choice of destination hospital affected.

Multicenter Study
Using a multi-center study should clarify the question whether the ultrasound examination without additional investigators from the rescue team at the accident site itself can be carried out and whether the additional diagnosis at the accident a change of the präklinisches management. When the multi-center study completed in December 2003, 5 air rescue centre from the DRF and Christoph 2 German border police were involved. Doctors and rescue assistants with no or minor ultrasound experience were specially-developed in the training program. After evaluation of more than 200 cases showed that in over 90% of the operations sufficient time was to carry out the ultrasound.Through the training of doctors and rescue assistants and standardization of the investigation process was the average period of investigation only 2.4 minutes.Free fluid were found in 14% of cases.There were only 2 false negative and 1 false positive diagnosis, which is a high sensitivity and specificity of more than 90%. The preclinical asked sonographic diagnosis was on average 35 minutes earlier than the sonography in shock room. In about 1/3 of the cases changed the team because of ultrasound diagnosis, the clinical management and therapy. The alarm image of the rescue teams to the control center has been in more than half of the cases to the information of the sonographic finding expands, so in about 1 / 5 of the stakes, the hospital aim was changed. In all cases with a positive result was the shock room of the receiving hospital team modified and extended.