Prospective Evaluation of Prehospital Trauma Ultrasound During Aeromedical Transport

Lung Ultrasound in Pneumothorax: The Continuing Need for Radiology

“…"With regard to lung ultrasound, sensitivity for pneumothorax was poor," despite the fact that "several studies have demonstrated very high sensitivity for lung ultrasound in diagnosing pneumothorax, but this was not replicated in our study" (1). "Negative interpretations were predictive, but low prevalence limited the value of these results.…”

“…Furthermore, in 120 patients with lack of pleural sliding under TUS, CT did not confirm pneumothorax.Consequently, in our series, TUS sensitivity was 91.95% (95% confidence interval [CI] 0.86-0.954), specificity 89.1% (95% CI 0.872-0.908). Although these figures may at first appear very different from those reported by Press et al (TUS sensitivity and specificity for pneumothorax: 18.7% [95% CI 8.9-33.9%] and 99.5% [95% CI 98.2-99.9%], they all point toward the same conclusion, namely, that TUS alone is not fit for this purpose(1). Indeed, because our false negatives (10%) and false positives were still high, 120/1105 subjects would have been erroneously diagnosed with pneumothorax and scheduled for unnecessary surgery, if only TUS findings were taken as read.…”

“…We were very pleased to read the important article by Press et al, in which they state "pneumothorax is frequently misdiagnosed by clinical examination, resulting in a rate of unnecessary needle decompression as high as 26%" (1). "With regard to lung ultrasound, sensitivity for pneumothorax was poor," despite the fact that "several studies have demonstrated very high sensitivity for lung ultrasound in diagnosing pneumothorax, but this was not replicated in our study" (1).…”

“…Indeed, because our false negatives (10%) and false positives were still high, 120/1105 subjects would have been erroneously diagnosed with pneumothorax and scheduled for unnecessary surgery, if only TUS findings were taken as read. Accordingly, we warned that emergency chest intervention should not be performed until chest radiograph or CT scan data are available, which is the recommendation implicit in the study by Press et al(1,4,5).…”

Prehospital ultrasound of the abdomen and thorax changes trauma patient management: A systematic review

“…Studies have found PHUS training to be feasible both with physicians [54,55] and non-physicians [53,[56][57][58][59][60]. Nonphysician use of PHUS in changing patient management has not been studied.…”