Portable ultrasound in disaster triage: a focused review

Abstract

Ultrasound technology has become ubiquitous in modern medicine. Its applications span the assessment of life-threatening trauma or hemodynamic conditions, to elective procedures such as image-guided peripheral nerve blocks. Sonographers have utilized ultrasound techniques in the pre-hospital setting, emergency departments, operating rooms, intensive care units, outpatient clinics, as well as during mass casualty and disaster management. Currently available ultrasound devices are more affordable, portable, and feature user-friendly interfaces, making them well suited for use in the demanding situation of a mass casualty incident (MCI) or disaster triage. We have reviewed the existing literature regarding the application of sonology in MCI and disaster scenarios, focusing on the most promising and practical ultrasound-based paradigms applicable in these settings.

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

“…30,31 On the other hand, ultrasound has some limitations as well as a very broad range of reported sensitivity and specificity for detecting free fluid and injuries in patients with major trauma. 32 In a MCI simulation study looking for free abdominal fluid detected by Focused assessment with sonography in trauma (FAST, also known as focused abdominal sonography for trauma), the authors observed a false-positive (5overtriage) rate of 59% and a sensitivity of 67%.…”

Enhanced Point‐of‐Care Ultrasound Applications by Integrating Automated Feature‐Learning Systems Using Deep Learning

“…Adopting new strategies and using existing technology to diagnose and treat patients in mass casualty incidents will save lives and limit morbidity. Point‐of‐care US has become a powerful tool for health care providers to use in disaster response medicine …”

Point of care ultrasound in disaster triage

“…Over-triaging, resource over-allocation to patients who turn out to have minor medical ailments, and under-triaging are difficulties with an estimated occurrence of about 10% for each. 2 It is possible that the dependence on history and physical examination, in the absence of medical imaging, contribute to this error. In the world of limited medical resources, such as military environments, POCUS has been demonstrated to be equally accurate to computed tomography (CT) scans in diagnosing pericardial effusion, pneumothorax and intraperitoneal fluid.…”

“…In the emergency department, the focused assessment with sonography for trauma (FAST) has become ubiquitous as a rapid and accurate way to rule out torso hemorrhage. 2 With improving portability and accessibility, POCUS has a number of features that lends itself to utility in diverse locations such as high altitude, refugee camps, military combat, and even the International Space Station. 2 Of particular interest, mass casualty incidents are an area where ultrasound offers an ideal pairing of portability and diagnostic power.…”