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Aeromedical Ultrasound: The Evaluation of Point-of-care Ultrasound During Helicopter Transport

Published:March 30, 2017DOI:https://doi.org/10.1016/j.amj.2017.02.001

      Abstract

      Introduction

      This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings.

      Methods

      This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina.

      Results

      For 190 trauma patients the Flight Crew POCUS examinations obtained a Positive Predictive Value (PPV) of 100% and a Negative Predictive Value (NPV) of 98.3% for the identification of pneumothorax, hemothorax, and free abdominal fluid, which is equivalent to that of the Trauma Team's POCUS studies on the same group of patients.

      Discussion

      Because the early recognition of potentially life-threatening conditions is critical to providing appropriate care to the traumatically injured patient this study provides solid statistical data that flight crews can adequately perform and interpret POCUS results as well as out trauma team colleagues. This study could lead to a reduction of iatrogenic injuries from unnecessary invasive prehospital procedures, allow for early initiation of Massive Transfusion Protocols (MTP) prior to the patient's arrival at the Trauma Center, and potentially develop a change in trauma systems notification and transportation directly to the operating room.

      Conclusion

      Despite this study developing a very positive outlook on performing aeromedical POCUS for the evaluation and care of trauma patients additional research will be required to better understand the potential impact on trauma activation protocols and activation of in-hospital resources.
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