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Apr 30, 2019

WADEM Congress on Disaster and Emergency Medicine 2019

Next Level Triage: Applications of Point-of-Care Ultrasound in Disaster Response and Recovery

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Triage

Mass casualty

ultrasound

POCUS

prehospital

Abstract

Abstract

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Keywords

Triage

Mass casualty

ultrasound

POCUS

prehospital

Abstract

Introduction: Ultrasound applications are widespread, and its utility in resource limited environments are numerous. In disasters, the use of ultrasound can help reallocate resources by guiding decisions on management and transportation priorities. These interventions can occur on scene, at triage collection points, during transport, and at the receiving medical facility. Literature related to this specific topic is limited with a large amount of information provided by anecdotal evidence. A comprehensive summary of current literature can provide disaster planners with a better understanding of studies available and help navigate avenues for future research. Aim: To evaluate the utility of point-of-care ultrasound in a disaster response based on studies involving ultrasonography in resource-limited environments. Method: A narrative review of MEDLINE, MEDLINE InProcess, EPub and Embase databases was conducted by two independent reviewers. Papers were also included using ancestry and hand searches. Results: A total of 1271 articles were found with this search strategy, and abstracts and titles were reviewed. Inclusion criteria included human subjects, available full text in English, use of ultrasound as primary modality and use in MCI, disasters, and triage scenarios. Exclusion criteria included ultrasounds performed outside of timeframe for immediate response (30 days post response) and articles not specific to disasters (focus on EMS, pre-hospital, space, austere, global health, and event medicine). When combined, 35 unique articles met criteria. Discussion: Current literature support the use of ultrasound in disaster response as a real-time, portable, safe, reliable, repeatable, easy-to-use, and accurate tool. While both false positives and false negatives were reported, these values correlate to accepted false positive and negative rates of standard in-hospital point-of-care ultrasound exams. Studies demonstrate the ability to apply ultrasound in extreme conditions and to obtain high-quality images with only modest training and real-time remote guidance. The potential for point of care ultrasound in triage and management of mass casualty incidents is there. However, as these studies are heterogenous and observational in nature, further research is needed as to how to integrate ultrasound into the response and recovery phases.

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© Copyright 2019 Morressier GmbH.
All rights reserved.