For EMS & Prehospital Teams

The monitor is an incomplete witness.

In out-of-hospital arrest, the rhythm strip can't see pseudo-PEA, fine VF, or tamponade. A bounded subcostal exam can — if it never costs a compression. Here's how EASy thinks about prehospital use, and where its evidence actually stands.

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The challenge

In out-of-hospital cardiac arrest, the monitor tells an incomplete story. It cannot distinguish true electromechanical dissociation from a heart still contracting without a palpable pulse, and fine ventricular fibrillation can read as asystole — distinctions that change the next action. In hospital, ultrasound during the rhythm check makes them. In the field, the same questions arrive with fewer hands and harsher conditions.

Paramedic-performed ultrasound is a young field, and honesty matters here: most prehospital POCUS programs are early, the evidence base is limited, and scope of practice varies system to system. What makes non-physician use conceivable at all is exactly what EASy was built around — one window, a deliberately bounded finding set, and a review loop where every image is saved and examined afterward.

How EASy fits

Acquire. Phenotype. Act.

Acquire

The subcostal window works where EMS works — on the floor, in the doorway, in the moving truck — and the exam runs on a handheld phased-array probe. Imaging happens inside the pauses that are already happening; it never adds to them. Compressions never wait for a picture.

Phenotype

In arrest the findings are deliberately few: standstill or organized motion, fine VF the monitor calls asystole, a pericardial effusion, an empty heart. Bounded enough to be trained, specific enough to change the next two minutes.

Act

Under local protocols and medical direction: shock the fine VF, give volume to the empty heart, treat the tension chest where it's in scope — and save every clip, so the arrest can be debriefed with the medical director afterward.

Scenarios

Where EASy fits in the field

Out-of-hospital cardiac arrest — EASy ALS

Case-series evidence

Standstill, pseudo-PEA, fine VF, tamponade — the reversible-cause exam, structured to respect the pulse check rather than prolong it.

Explore

Transport hypotension — EASy MAP

Published method

Ten phenotypes for the hypotensive patient in the truck or on an interfacility run — fast enough to repeat when the patient changes.

Explore

Prehospital RSI — EASy PDA

Case-series evidence

A pre-induction phenotype for HEMS and critical care transport teams who intubate in the field.

Explore

The published numbers

4 minEASy

16 minFocused TTE

Average examination time for novice sonographers in the published comparison. A protocol that costs a quarter of the time gets repeated when the patient changes.

Fiorini & Basmaji, Can J Anaesth 2022

87%

After one day of focused training, novice residents obtained images sufficient for supervised clinical decision-making in 87% of 63 examinations — averaging 4.3 minutes each. Day one is about acquisition; interpretation stays supervised.

Crit Care Explor 2024

Where the evidence stands — read this first

EASy's published studies are in-hospital and physician-performed; the EASy ALS series is resident-performed, in-hospital arrests. There is no prehospital EASy study yet, and this page doesn't claim one. For a non-physician service, EASy is a medical-direction project: scope-of-practice approval, a defined training and sign-off pathway, and post-event review of every clip with the service's medical director. And ultrasound findings alone — including cardiac standstill — are not a termination-of-resuscitation rule; that decision stays with medical direction.

All evidence & independent review

Resources