This study attempts to replicate data from a similar study performed 5 years ago by
comparing point-of-care (POCUS) extended focused abdominal sonography in trauma (eFAST)
examinations performed by an air medical flight crew with those performed by a trauma
team at a level 1 trauma center.
This prospective observational study evaluated 174 trauma patients over a 12-month
period in southeastern Virginia and northeastern North Carolina.
For 101 trauma patients who had a POCUS evaluation completed by the flight crews,
a positive predictive value of 100% was obtained with a negative predictive value
of 96.63% for pneumothorax, hemothorax, and free abdominal fluid. This showed no significant
difference in that of the trauma team's POCUS studies or that of the data from the
2017 study. Early recognition of life-threatening injury continues to be a priority
during the assessment of traumatically injured patients. In conjunction with a thorough
history and physical examination, POCUS is a very effective method to identify these
potentially devastating injuries, especially in the air medical community. When we
compared this study's results with those of our study from 2017, the data were very
similar, showing that flight crews can conduct POCUS examinations effectively in the
austere prehospital environment.
By replicating this study, we have shown the validity and continued quality, accuracy,
and benefits of the POCUS eFAST examination of trauma patients in the air medical
environment. The validity of our previous and now current research suggests that some
current standard trauma protocol revisions are indicated (ie, the initiation of air
medical trauma resuscitation with blood products, preferably whole blood, and the
transport of critically injured patients with a positive POCUS examination for free
abdominal fluid directly to the operating room should be closely evaluated).