Is trauma ultrasound feasible during helicopter transport?
Poster, Critical Care Transport Medicine Conference and Society for Academic Emergency Medicine Western Regional Conference, Las Vegas, NV, April 18-20, 2000
Dan D. Price, MD*, Sharon R. Wilson, MD and Terry G. Murphy, MD, Oregon Health Sciences University and Life Flight Network, Portland, Oregon*, UC Davis Medical Center and UCMDC Life Flight, Sacramento, California#
Objective
To evaluate the feasibility of performing a standard 4 view focused abdominal sonography for trauma (FAST) exam during helicopter transport using a new, 5.4 lb, hand-carried ultrasound machine.
Methods
In the prospective observational study, actual and simulated trauma patients were evaluated using the SonoSite 180 ultrasound machine by 2 air transport programs servicing 3 Level I trauma centers. FAST exams were performed in flight by emergency medicine faculty, residents, flights nurses, and ultrasound technologists, who rated the difficulty posed by various factors using Likert scales (0="not difficult" to 5="impossible.") BK 117, Bell 230, and BO 105 medical helicopters flew in all aviating modes. Pilots were queried regarding avionics variations throughout the flight.
Results
Ten flight sonographers performed 21 FAST exams on 14 patients (5 actual, 9 simulated). The media Likert value for each parameter was 0, "not difficult," except for patient position which was 1, "somewhat difficult." Interquartile ranges were 0-0 for vibration, bedding, IV catheters, monitor cables and ventilator, 0-0.5 for backboard straps, and 0-1 for sunlight, patient position, spider straps, gurney straps, and clothing. Mean exam duration was 3.0 minutes (range 1.5-5.5, SD 1.3). Pilots reported no avionics effects in any flight mode.
Conclusion
The FAST exam using the SonoSite 180 in flight was rated by 10 evaluators to be easily performed. Exams were conducted quickly and did not interfere with helicopter avionics. This is the first digital ultrasound machine small enough to be used in most medical helicopters.
Acknowledgement
We would like to thank Gina Scarr, RN, for helping to coordinate flight nurse ultrasound training and research in general, and SonoSite, Inc., for loaning us equipment to perform this study.
Reprinted with permission of Dan D. Price, M.D.