Prehospital emergency ultrasound (PEU) is being increasingly used in different preclinical emergency systems across the world. Ultrasound examinations in emergency situations, however, remain challenging even in the hospital setting despite the availability of standardized approaches such as Focused Assessment with Sonography for Trauma (FAST). Preclinical circumstances further complicate the adequate execution of an additional diagnostic tool such as PEU on the scene or inside a medical emergency vehicle. Furthermore, rapid translation of ultrasound findings into meaningful therapeutic consequences is considerably demanding in an environment of limited resources. If focused PEU is correctly used and patients' condition allows emergency doctors a careful ultrasound examination, it is possible to differentiate life-threatening diagnoses. PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems. To date it is unclear whether PEU results in improved outcome.

Some emergency cases present difficult challenges in the prehospital ultrasound examination. Portable devices designed for PEU suggest the possibility of increasing the use of ultrasound "in the field". However, to the investigator's knowledge, opportunities for real-time consultation with a second specialist including live transmission of the ultrasound picture are not being provided at any preclinical emergency facility.

Aim 1:

Feasibility of real time prehospital emergency ultrasound (PEU) transmission in a university affiliated preclinical emergency system.

Aim 2:

Identify obstacles for PEU transmission including a real time consultation of an ultrasound expert.

Hypothesis:

We expect that live streaming of emergency ultrasound images in order to allow a second opinion could improve diagnostics of life threatening conditions and help us to improve patients' safety by digital health. The use of PEU is feasible and safe.

Inclusion Criteria:

Emergency patients affected by:

• trauma
• cardiac arrest/shock
• respiratory problems

Exclusion Criteria:

• Patients rejection.
• Legal representative's rejection.

PEU should be implemented in the management of emergency patients affected by trauma, cardiac arrest/shock or respiratory problems.