The goal of this prospective observational study is to develop and assess the core ultrasound applications for emergency medical technicians (EMTs) in Taiwan. The study focuses on advanced emergency medical technicians (EMT-Ps) and their ability to perform point-of-care ultrasound (POCUS) in prehospital settings.

The main questions it aims to answer are:

Can a standardized POCUS training program improve EMT-Ps' competency in ultrasound applications? What is the reliability and validity of the newly established POCUS assessment modules for EMT-Ps? Researchers will compare trained EMT-Ps' ultrasound proficiency and clinical decision-making before and after training to see if structured POCUS education enhances diagnostic accuracy and patient care in prehospital settings.

Participants will:

Attend a structured POCUS training program, including lectures and hands-on practice with standardized patients and simulation models.

Undergo competency assessments, including written exams, objective structured clinical examinations (OSCEs), and image interpretation tests.

Perform ultrasound scans on actual patients in prehospital settings, focusing on trauma, respiratory distress, stroke, and cardiac arrest cases.

Receive feedback and participate in follow-up assessments to evaluate knowledge retention and clinical application.

Inclusion Criteria:

• Patients presenting with one of the following conditions in the prehospital setting:

Trauma Dyspnea (shortness of breath) Suspected stroke Out-of-hospital cardiac arrest (OHCA)

Exclusion Criteria:

• Patients with hemodynamic instability or critical conditions requiring immediate resuscitation, making them unsuitable for focused prehospital ultrasound performed by EMT-Ps.
• Patients under the age of 18.