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Portable ultrasound in pre‐hospital emergencies: a feasibility study

2006; Wiley; Volume: 50; Issue: 6 Linguagem: Inglês

10.1111/j.1399-6576.2006.01030.x

1399-6576

Michael P. Busch,

Trauma and Emergency Care Studies

Background: Ultrasound plays a central role in the evaluation of both trauma and medical emergencies. The development of portable sonography devices could extent its application into the pre‐hospital arena. The aim of our study was to evaluate feasibility of pre‐hospital ultrasound in the Norwegian Air Rescue setting. Material and methods: During a 3‐month period, we conducted a prospective study using sonography in pre‐hospital patient management. All examinations were carried out by the same ultrasound‐certified physician using a Primedic™ Handyscan in a standardized focused protocol for abdominal and lung sonography and a subcostal 2‐chamber long axis view. Inclusion criteria were abdominal/thoracic and obstetric trauma, circulatory/respiratory compromise, pulseless electric activity (PEA) in cardiac arrest, acute abdomen and monitoring during transport. Allowed examination time was restricted to 3 min on the scene. The patient’s gender, age, symptoms, trauma mechanism, quality of visualization and diagnose made were recorded. Pre‐hospital results were compared with in‐hospital findings. Results: Thirty‐eight patients were entered into the study. Three patients had to be excluded due to technical difficulties. Nineteen medical, 15 traumas and 1 obstetric patient were included. Good visualization was obtained in 74% ( n = 26), moderate in 26% ( n = 9). Median examination time was 2.5 min (range 1–3 min). Nine patients (26%) showed positive sonography findings. Sensitivity was 90%, specificity 96%. Diagnostic usefulness was high in undetermined cardiac arrest and hypotension and massive hematoperitoneum. Conclusion: Pre‐hospital ultrasound when applied by an proficient examiner using a goal‐directed, time sensitive protocol is feasible, does not delay patient management and provides diagnostic and therapeutic benefit. Further studies are warranted to identify the exact indications and role of pre‐hospital sonography.