Boniface Keith S, Sikka Neal, Page Nicholas, Peretz Asi, Shokoohi Hamid
The George Washington University, 2120 L Street NW, Suite 450, 20037 Washington, DC, United States.
No affiliation.
Int Marit Health. 2020;71(1):42-45. doi: 10.5603/IMH.2020.0010.
Cruise ships travel far from shoreside medical care and present a unique austere medical environment. For the cruise ship physician, decisions regarding emergency medical evacuation can be challenging. In the event that a passenger or crew member becomes seriously ill or is injured, the use of point-of-care ultrasound may assist in clarifying the diagnosis and stratifying the risk of a delayed care, and at times expedite an emergent medical evacuation. In this report we present the first case reported in the literaturę of an emergency medical evacuation from a cruise ship triggered by handheld ultrasound. A point-of-care ultrasound performed by a trained cruise ship physician, reviewed by a remote telemedical consultant with experience in point-of-care ultrasound, identified an ectopic pregnancy with intraabdominal free fluid in a young female patient with abdominal pain and expedited emergent helicopter evacuation from a cruise ship to a shoreside facility, where she immediately underwent successful surgery. The case highlights a medical evacuation that was accurately triggered by utilising a handheld ultrasound and successfully directed via a tele-ultrasound consultation. American College of Emergency Physicians (ACEP) health care guidelines for cruise ship medical facilities should be updated to include guidelines for point-of-care ultrasound, including training and telemedical support.
游轮航行至远离岸边医疗救助的地方，呈现出独特的严峻医疗环境。对于游轮医生而言，做出紧急医疗后送的决策可能具有挑战性。倘若乘客或船员身患重病或受伤，使用即时超声检查或许有助于明确诊断并评估延迟治疗的风险，有时还能加快紧急医疗后送的进程。在本报告中，我们呈现了文献中首例由手持超声引发的游轮紧急医疗后送病例。一名经过培训的游轮医生进行了即时超声检查，并由一位具备即时超声检查经验的远程远程医疗顾问进行了复查，检查发现一名腹痛年轻女性患者存在宫外孕且腹腔内有游离液体，从而加快了从游轮紧急直升机后送至岸边医疗机构的速度，她在那里立即接受了成功的手术。该病例凸显了一次通过使用手持超声准确触发并经远程超声会诊成功指导的医疗后送。美国急诊医师学会（ACEP）针对游轮医疗设施的医疗保健指南应予以更新，纳入即时超声检查指南，包括培训和远程医疗支持。
