Diagnosis and Treatment of a Ruptured Ectopic Pregnancy in a Combat Support Hospital during Operation Iraqi Freedom: Case Report and Critique of a Field-Ready Sonographic Device

Abstract

This case report describes a novel diagnostic approach for ectopic pregnancy in a combat environment. We diagnosed a ruptured ectopic pregnancy at our combat support hospital by using the SonoSite 180 Plus ultrasound device (SonoSite, Bothell, WA). The live ectopic pregnancy was immediately identified and the entire pelvic anatomy was easily assessed within 5 minutes. The SonoSite ultrasound device proved to be easy to use, durable, and reliable. It produced high-quality images in a variety of applications. The handheld SonoSite 180 ultrasound device is sufficiently portable to be used effectively in a combat support hospital or field situation, such as a forward surgical team. This combat experience suggests that a handheld ultrasound device may also have great utility during patient transport for civilian hospitals.

Use of ultrasound by emergency medical services: a review

“…When used in a field hospital in Iraq, a portable ultrasound device was used in conditions of limited space, high ambient temperature and light, and often under battery power [13]. Other authors in a similar military environment found portable ultrasound to have “great utility in the field or during patient transport” [14]. …”

Portable Ultrasound for Remote Environments, Part I: Feasibility of Field Deployment

“…The authors noted that the scans improved their diagnostic capacity and helped prevent unnecessary evacuation to higher-level facilities out of theater solely for radiologic imaging. In a recent case report of a ruptured ectopic pregnancy diagnosed in a field hospital setting with portable ultrasound, the authors subjectively described good image quality and durability throughout the deployment of the device (28). The device in this study was exposed to heat, wind, and sand, and the authors report that it was well suited to use in a field hospital or during transport.…”

A Comparison of Portable Ultrasound and Fully-Equipped Clinical Ultrasound Unit in the Thyroid Size Measurement of the Indo-Pacific Bottlenose Dolphin

“…Despite the controversy in objectively defining the image quality [30], [31], there is no doubt that differential diagnosis was confirmed when a more advanced clinical ultrasound unit was used, which inevitably produced higher quality ultrasound images for clinical diagnosis. Studies have suggested that PUS provides a significant benefit that can drastically alter the disposition and treatment in patients at Accident and Emergency Departments, Intensive Care Units, small-scale hospitals and remote location settings [30], [32]–[34]. In view of the concerns raised from zoological and aquarium settings, a PUS could play an adequate role in improving a variety of veterinary procedures by providing a real-time, non-invasive clinical tool.…”