Focused Assessment with Sonography for Trauma in Weightlessness: A Feasibility Study

Kirkpatrick, Andrew W.; Hamilton, Douglas R.; Nicolaou, Savvas; Sargsyan, Ashot E.; Campbell, Mark; Feiveson, Alan H.; Dulchavsky, Scott A.; Melton, Shannon; Beck, George; Dawson, David L.

doi:10.1016/s1072-7515(02)01906-3

Cited by 48 publications

(28 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Point-of-care ultrasound has been successfully performed in a number of austere medical locations including low Earth orbit, mountain peaks, polar outposts, submarines, underserved rural locations, and combat areas [4][5][6][7][9][10][11][12][13]. Novel training techniques such as remote expert guidance and virtual guidance serve to enable the nonexpert operator to utilize this robust, portable, and affordable technology to enhance medical diagnostic capabilities on and off the planet.…”

Section: Discussionmentioning

confidence: 99%

Virtual guidance: a new technique to empower point-of-care ultrasound in remote or extreme environments

et al. 2010

View full text Add to dashboard Cite

Purpose Remote guidance techniques have been developed by NASA researchers to allow non-clinicians to perform complex ultrasound examinations on the International Space Station to increase clinical diagnostic capabilities. Real-time or near real-time communication will not be an option for missions beyond the Earth and Moon; non-experts will have to scan autonomously. We investigated the ability of non-experts to perform point-of-care ultrasound in a remote location using ''virtual guidance'', consisting of a video-based training and troubleshooting guide to acquire cardiac ultrasound images. Methods Non-expert operators (n = 4) reviewed a short (\15 min) cardiac ultrasound examination training video using dedicated video glasses and an iPod. They then acquired echocardiography scansets on normal, volunteer subjects at Resolute Bay, Canada using a portable ultrasound device. Image quality was evaluated using a scoring system by two experts in echocardiography. ResultsCardiac ultrasound examinations were autonomously completed by four non-expert operators using virtual guidance in under 30 min and judged to be adequate for clinical interpretation. Virtual guidance with the video glasses and streaming examination guide was accepted by all operators as an effective guidance technique for this purpose. Conclusions Virtual guidance is a novel technique that may allow data acquisition by non-expert operators autonomously when on-site expertise or real time support is not available. Further refinement of the technique should be explored to enhance autonomous medical capabilities in isolated or underserved settings, either on or off the planet.

show abstract

Section: Discussionmentioning

confidence: 99%

Virtual guidance: a new technique to empower point-of-care ultrasound in remote or extreme environments

et al. 2010

View full text Add to dashboard Cite

show abstract

“…On the International Space Station, non-physician astronauts were able to obtain adequate normal FAST images in an average of 5.5 min in microgravity conditions (13,14). Another study of the sensitivity of the FAST in microgravity determined that sonographers could detect peritoneal fluid in a porcine model at 0 g and 1.8 g environments.…”

Section: Indicationsmentioning

confidence: 99%

Portable Ultrasound for Remote Environments, Part II: Current Indications

Nelson

Melnick

2011

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…North American interest in this technique was greatly facilitated by specific space medicine-related needs arising from the presence aboard the International Space Station of a high quality ultrasound capability, without any other medical diagnostic capabilities. NASA-associated research thus examined basic science and clinical questions both in terrestrial-and space-analog environments [23,29,[36][37][38][39][40][41][42]. In the course of these investigations it became apparent that there were frequently cases whereby ultrasound appeared to be more sensitive in detecting pneumothoraces after trauma than the supine chest radiograph [8-10, 23, 43].…”

Section: The Examination: the Expanded Fast Examinationmentioning

confidence: 99%

Opening Pandora’s box: the potential benefit of the expanded FAST exam is partially confounded by the unknowns regarding the significance of the occult pneumothorax

et al. 2010

View full text Add to dashboard Cite

Introduction Point of care (POC) ultrasound brings another powerful dimension to the physical examination of the critically ill. A contemporary challenge for all care providers, however, is how to best incorporate ultrasound into contemporary algorithms of care. When POC ultrasound corroborates pre-examination clinical suspicion, incorporation of the findings into decision-making is easier. When POC ultrasound generates new or unexpected findings, decision-making may be more difficult, especially with conditions that were previously not appreciated with older diagnostic technologies. Pneumothoraces (PTXs), previously seen only on computed tomography and not on supine chest radiographs known as occult pneumothoraces (OPTXs), which are now increasingly appreciated on POC ultrasound, are such an example.Methods The relevant literature concerning POC ultrasound and PTXs was reviewed after an electronic search using PubMed supplemented by ongoing research by the Canadian Trauma Trials Collaborative of the Trauma Association of Canada. Results OPTXs are frequently encountered in the critically injured who often require mechanical ventilation with positive pressure breathing (PPB). Standard recommendations for post-traumatic PTXs and the setting of PPB mandate chest drainage, recognizing a significant rate of complications related to this procedure itself. Whether these standard recommendations generated in response to obvious overt PTXs apply to these more subtle OPTXs is currently unknown, and evidence-based recommendations regarding appropriate therapy are impossible due to the lack of clinical studies. Conclusions OPTXs are a condition that illustrates how incorporation of POC ultrasound findings brings further responsibilities to critically appraise the significance of these findings in terms of patient outcomes and overall care. Adequately powered and adequately followed-up clinical trials addressing the treatment are required.Keywords Point of care ultrasound Á Critical ultrasound Á Pneumothorax Á Occult pneumothorax Á Critical care Á Mechanical ventilation Electronic supplementary material The online version of this article (

show abstract

Focused Assessment with Sonography for Trauma in Weightlessness: A Feasibility Study

Cited by 48 publications

References 40 publications

Virtual guidance: a new technique to empower point-of-care ultrasound in remote or extreme environments

Virtual guidance: a new technique to empower point-of-care ultrasound in remote or extreme environments

Portable Ultrasound for Remote Environments, Part II: Current Indications

Opening Pandora’s box: the potential benefit of the expanded FAST exam is partially confounded by the unknowns regarding the significance of the occult pneumothorax

Contact Info

Product

Resources

About