Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA.
Prehosp Disaster Med. 2012 Apr;27(2):172-7. doi: 10.1017/S1049023X12000611. Epub 2012 May 17.
A 7.0 magnitude earthquake struck Haiti on January 12, 2010, resulting in 222,000 deaths and 300,000 injuries. Three weeks after the initial quake, the New Mexico Disaster Medical Assistance Team (NM DMAT-1) was deployed to Haiti for ongoing medical relief. During this deployment, a portable handheld ultrasound machine was tested for usefulness in aiding with patient care decisions.
The utility of portable ultrasound to help with triage and patient management decisions in a major disaster setting was evaluated.
Retrospective observational non-blinded images were obtained on 51 patients voluntarily presenting to the Gheskio Field clinic at Port-au-Prince. Ultrasound was used for evaluation of undifferentiated hypotension, torso trauma, pregnancy, non-traumatic abdominal pain, deep venous thrombosis and pulmonary embolism, and dyspnea-chest pain, as well as for assisting with procedures. Scans were obtained using a Signos personal handheld ultrasound machine with images stored on a microSD card. Qualitative data were reviewed to identify whether ultrasound influenced management decisions, and results were categorized in terms of percent of scans that influenced management.
Fifty-one ultrasound scans on 50 patients were performed, with 35% interpreted as positive, 41% as negative, and 24% as equivocal. The highest yields of information were for abdominal ultrasound and ultrasound related to pregnancy. Ultrasound influenced decisions on patient care in 70% of scans. Most of these decisions were reflected in the clinician's confidence in discharging a patient with or without non-emergent follow-up.
The use of a handheld portable ultrasound machine was effective for patient management decisions in resource-poor settings, and decreased the need to triage selected patients to higher levels of care. Ultrasound was very useful for evaluation of non-traumatic abdominal pain. Dynamic capability is necessary for ultrasound evaluation of undifferentiated hypotension and cardiac and lung examinations. Ultrasound also was useful for guidance during procedural applications, and for aiding in the diagnosis of parasitic diseases.
2010 年 1 月 12 日，海地发生 7.0 级地震，造成 22.2 万人死亡，30 万人受伤。震后三周，新墨西哥灾难医疗援助队（NM DMAT-1）被部署到海地，提供持续的医疗救援。在此部署期间，对便携式手持超声机在帮助患者护理决策方面的实用性进行了测试。
评估便携式超声在重大灾害环境中帮助分诊和患者管理决策的效用。
对自愿前往太子港 Gheskio 野外诊所的 51 名患者进行回顾性观察性非盲图像采集。使用超声评估无法区分的低血压、躯干创伤、妊娠、非创伤性腹痛、深静脉血栓形成和肺栓塞以及呼吸困难-胸痛，以及协助进行手术。使用 Signos 个人手持超声机进行扫描，并将图像存储在 microSD 卡上。对定性数据进行回顾，以确定超声是否影响管理决策，并根据影响管理的扫描百分比对结果进行分类。
对 50 名患者的 51 次超声扫描进行了检查，其中 35%的结果为阳性，41%的结果为阴性，24%的结果为不确定。提供信息量最大的是腹部超声和与妊娠相关的超声。70%的超声扫描影响了患者的护理决策。这些决策大多反映在临床医生对患者是否有非紧急随访进行分诊的信心上。
在资源匮乏的环境中，使用便携式手持超声机可有效进行患者管理决策，并减少将选定患者分诊到更高护理水平的需求。超声对于评估非创伤性腹痛非常有用。对于无法区分的低血压和心脏及肺部检查，超声的动态能力是必要的。超声还可用于指导手术应用，并有助于寄生虫病的诊断。
