Page 138 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars

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Chapter 6
Abstract
Background
Due to advancements in technology, the use of a portable ultrasound (US) machine in the out-of-hospital setting is increasingly feasible. It has diagnostic and therapeutic advantages and may improve the management and treatment of patients. It can be used in-flight and can be easily taught to flight clinicians who have little previous experience with this modality.
Study Objectives
The aim of this study was to evaluate the impact of ultrasound chest examinations on the care of patients treated by a helicopter emergency medical service (HEMS).
Methods
Since 2007, portable US has been used by the HEMS of Nijmegen, the Netherlands. Data on every air medical flight are routinely collected in a database. Every portable US examination of the chest performed between 2007 and 2010 was reviewed for this study. Data on patient characteristics, properties of US examinations, US diagnoses, and impact on medical treat- ment were collected and analyzed.
Results
Of a total of 2572 patients, 326 portable US examinations of the chest were performed in 281 (11%) patients. The mean duration of a portable US examination was 2.77 (SD 1.30) min, and the duration decreased over time. After the US examination, the plan for treatment changed in 60 (21%) patients. In 10 patients (4%) the plan to place a chest tube was abandoned. In ten patients (4%) the initially selected destination for definitive care changed, and it changed to a lower-level hospital more often than to a higher-level one. In nine patients (3%), cardiopul- monary resuscitation was stopped and in 31 patients there were other changes.
Conclusions
Out-of-hospital US examinations may alter and improve treatment decisions and destina- tions for definitive care.