1Department of Emergency Medicine,University of Arizona Medical Center,Tucson,ArizonaUSA.
2Department of Internal Medicine,University of South Carolina School of Medicine,Columbia,South CarolinaUSA.
Prehosp Disaster Med. 2014 Jun;29(3):290-3. doi: 10.1017/S1049023X14000375. Epub 2014 Apr 16.
Disaster management is a complex and difficult undertaking that may involve limited health care resources and evaluation of multiple victims. The objectives of this study were to evaluate the feasibility of real-time ultrasound video transmission from a simulated disaster triage location via commercially available video mobile phones and assess the ability of emergency physicians to accurately interpret the transmitted video of Focused Assessment with Sonography for Trauma (FAST) ultrasound examinations.
This was a prospective, observational study that took place at a simulated disaster scene put on for an Advanced Disaster Life Support (ADLS) course. The second component occurred at a Level I academic urban emergency department (ED) with an annual census of 78,000. Nineteen subjects at a simulated disaster scene were scanned using a SonoSite Titan ultrasound system (Bothell, Washington USA). An off-the-shelf, basic, video-capable mobile phone was used to record each ultrasound examination; and then immediately transmit the videos to another mobile phone approximately 170 miles away. The transmitted video was received by three emergency physicians with hospital credentialing in emergency ultrasound. Each FAST examination video was assessed for pathology, such as free fluid. The reviewers graded the image quality and documented the overall confidence level regarding whether or not a complete and adequate examination was visualized. Spearman's rank correlation coefficient was used to examine the agreement between the reviewers and the sonologist who performed the ultrasound examinations.
A total of 19 videos were transmitted. The median time for transmission of a video was 82.5 seconds (95% CI, 67.7 seconds-97.3 seconds). No video failed to transmit correctly on the first attempt. The image quality ratings for the three reviewers were 7.7, 7.5, and 7.4 on a 10-point Likert scale. There was a moderate agreement between the reviewers and sonologist in image quality rating and overall confidence level scores (rho = 0.6).
Real-time portable ultrasound video transmission via commercially available video mobile phones from a simulated disaster triage location is feasible and emergency physicians were able to accurately interpret video of FAST ultrasound examinations.
灾难管理是一项复杂而困难的任务，可能涉及有限的医疗资源和对多名伤员的评估。本研究的目的是评估通过市售视频移动电话从模拟灾难分诊地点实时传输超声视频的可行性，并评估急诊医师准确解读传输的创伤超声重点评估（FAST）超声检查视频的能力。
这是一项前瞻性观察研究，在高级灾难生命支持（ADLS）课程中进行模拟灾难现场进行。第二部分在一家拥有 78,000 名年度普查的一级学术城市急诊部进行。在模拟灾难现场对 19 名受试者使用 SonoSite Titan 超声系统（美国华盛顿州 Bothell）进行扫描。使用现成的、基本的、带视频功能的移动电话记录每次超声检查；然后立即将视频传输到大约 170 英里外的另一部移动电话。传输的视频由具有医院急诊超声认证的三位急诊医师接收。对每个 FAST 检查视频进行病理评估，例如游离液体。审查者对图像质量进行评分，并记录对是否可以看到完整和充分的检查的总体置信水平。使用 Spearman 等级相关系数检查审查者与进行超声检查的超声医师之间的一致性。
共传输了 19 个视频。传输视频的中位数时间为 82.5 秒（95%CI，67.7 秒-97.3 秒）。没有一个视频在第一次尝试时未能正确传输。三位审查者的图像质量评分分别为 10 分制的 7.7、7.5 和 7.4 分。在图像质量评分和整体置信水平评分方面，审查者与超声医师之间存在中度一致性（rho=0.6）。
通过市售视频移动电话从模拟灾难分诊地点实时传输便携式超声视频是可行的，急诊医师能够准确解读 FAST 超声检查的视频。
