**5. Conclusions**

This study confirms that the practice of conducting ultrasound scans in primary care reduces the environmental impact of atmospheric pollutants emitted by vehicles by avoiding the journeys which would have been necessary to carry out the scans by attending a specialized radiology service. The avoided journey results in savings of time and money for the user in addition to the reduction of fuel consumption and the emission of atmospheric pollutants. Other studies ought to analyse the potential impact of expanding the portfolio of primary care services on the potential savings in journeys made and their implications for the patients' work and personal life.

The increase in the number of POCUS programs, which has started to include the use of portable devices (hand-carried or hand-held ultrasounds) in patients' homes in rural and low-income settings [39–42], ought to be seen as a new tool and part of a broader strategy to reduce emissions of air pollutants.

Earth pollution and climate change is a reality. The modern healthcare sector contributes towards this grave phenomenon and, at the same time, it is being a ffected by it. The present study was thus conducted to identify one of the multiple ways in which the health sector can contribute to prevent climate change. Private car travel is a major source of air pollution and Telemedicine has the potential to minimize it by reducing journeys [43]. Potential air pollutant savings are strongly associated with the number of users and appointments that can be replaced by teleconsultations or point-of-care visits. The benefits will depend on the amount, the distance and type of transportation replaced by those visits. Local health initiatives, as modest they are, could contribute to expand this new model of Green Health. Maybe the results of this study can contribute to extending the POCUS model, increasing its future environmental impact.

**Author Contributions:** Conceptualization, F.X.M.-G. and J.V.-A.; methodology, F.X.M.-G., J.V.-A. and J.M.P.; validation, F.X.M.-G., J.V.-A. and J.M.P.; formal analysis, F.X.M.-G.; investigation, F.X.M.-G.; resources, F.X.M.-G., V.C.C., M.R.M., A.D.S., A.N.M.; data curation, F.X.M.-G.; writing—original draft preparation, F.X.M.-G., J.V.-A. and J.M.P.; writing—review and editing, F.X.M.-G. and J.V.-A. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Acknowledgments:** We would like to express our gratitude to the Unitat d'Investigació de Catalunya Central for their collaboration in conducting the study and to all those PHC professionals who registered the point-of-care ultrasounds from their primary care centers in Osona county. The study was carried out within the framework of the PROSAASU research group.

**Conflicts of Interest:** The authors declare no conflict of interest.
