Sargsyan Ashot E, Hamilton Douglas R, Jones Jeffrey A, Melton Shannon, Whitson Peggy A, Kirkpatrick Andrew W, Martin David, Dulchavsky Scott A
Wyle Laboratories, Houston, Texas, USA.
J Trauma. 2005 Jan;58(1):35-9. doi: 10.1097/01.ta.0000145083.47032.78.
Focused assessment with sonography for trauma (FAST) examination has been proved accurate for diagnosing trauma when performed by nonradiologist physicians. Recent reports have suggested that nonphysicians also may be able to perform the FAST examination reliably. A multipurpose ultrasound system is installed on the International Space Station as a component of the Human Research Facility. Nonphysician crew members aboard the International Space Station receive modest training in hardware operation, sonographic techniques, and remotely guided scanning. This report documents the first FAST examination conducted in space, as part of the sustained effort to maintain the highest possible level of available medical care during long-duration space flight.
An International Space Station crew member with minimal sonography training was remotely guided through a FAST examination by an ultrasound imaging expert from Mission Control Center using private real-time two-way audio and a private space-to-ground video downlink (7.5 frames/second). There was a 2-second satellite delay for both video and audio. To facilitate the real-time telemedical ultrasound examination, identical reference cards showing topologic reference points and hardware controls were available to both the crew member and the ground-based expert.
A FAST examination, including four standard abdominal windows, was completed in approximately 5.5 minutes. Following commands from the Mission Control Center-based expert, the crew member acquired all target images without difficulty. The anatomic content and fidelity of the ultrasound video were excellent and would allow clinical decision making.
It is possible to conduct a remotely guided FAST examination with excellent clinical results and speed, even with a significantly reduced video frame rate and a 2-second communication latency. A wider application of trauma ultrasound applications for remote medicine on earth appears to be possible and warranted.
创伤超声重点评估（FAST）检查已被证明由非放射科医生进行时，对于诊断创伤是准确的。最近的报告表明，非医生也可能能够可靠地进行FAST检查。国际空间站上安装了一个多功能超声系统，作为人类研究设施的一个组成部分。国际空间站上的非医生机组人员接受了有关硬件操作、超声技术和远程引导扫描的适度培训。本报告记录了在太空中进行的首次FAST检查，这是在长期太空飞行期间维持尽可能高水平的可用医疗护理的持续努力的一部分。
一名接受过最少超声检查培训的国际空间站机组人员，在任务控制中心的一名超声成像专家通过专用实时双向音频和专用天地视频下行链路（7.5帧/秒）的远程引导下，进行了一次FAST检查。视频和音频都有2秒的卫星延迟。为便于进行实时远程医疗超声检查，机组人员和地面专家都有相同的显示拓扑参考点和硬件控制的参考卡。
一次包括四个标准腹部视窗的FAST检查在大约5.5分钟内完成。根据任务控制中心专家的指令，机组人员顺利获取了所有目标图像。超声视频的解剖内容和逼真度都非常好，足以用于临床决策。
即使视频帧率显著降低且通信延迟为2秒，也有可能进行具有出色临床效果和速度的远程引导FAST检查。创伤超声应用在地球上远程医疗中的更广泛应用似乎是可能且有必要的。
