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Portable Handheld Ultrasound in Austere Environments: Use in the Haiti Disaster

Published online by Cambridge University Press:  17 May 2012

Meghan Shorter  and
Darryl J. Macias
Meghan Shorter
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico USA
Darryl J. Macias*
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico USA
*
Correspondence: Darryl J. Macias, MD Department of Emergency Medicine MSC 10 5560 1 University of New Mexico Albuquerque, NM 87131 USA E-mail dmacias@salud.unm.edu
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Abstract

Introduction

A 7.0 magnitude earthquake struck Haiti on January 12, 2010, resulting in 222,000 deaths and 300,000 injuries. Three weeks after the initial quake, the New Mexico Disaster Medical Assistance Team (NM DMAT-1) was deployed to Haiti for ongoing medical relief. During this deployment, a portable handheld ultrasound machine was tested for usefulness in aiding with patient care decisions.

Objective

The utility of portable ultrasound to help with triage and patient management decisions in a major disaster setting was evaluated.

Methods

Retrospective observational non-blinded images were obtained on 51 patients voluntarily presenting to the Gheskio Field clinic at Port-au-Prince. Ultrasound was used for evaluation of undifferentiated hypotension, torso trauma, pregnancy, non-traumatic abdominal pain, deep venous thrombosis and pulmonary embolism, and dyspnea-chest pain, as well as for assisting with procedures. Scans were obtained using a Signos personal handheld ultrasound machine with images stored on a microSD card. Qualitative data were reviewed to identify whether ultrasound influenced management decisions, and results were categorized in terms of percent of scans that influenced management.

Results

Fifty-one ultrasound scans on 50 patients were performed, with 35% interpreted as positive, 41% as negative, and 24% as equivocal. The highest yields of information were for abdominal ultrasound and ultrasound related to pregnancy. Ultrasound influenced decisions on patient care in 70% of scans. Most of these decisions were reflected in the clinician's confidence in discharging a patient with or without non-emergent follow-up.

Conclusion

The use of a handheld portable ultrasound machine was effective for patient management decisions in resource-poor settings, and decreased the need to triage selected patients to higher levels of care. Ultrasound was very useful for evaluation of non-traumatic abdominal pain. Dynamic capability is necessary for ultrasound evaluation of undifferentiated hypotension and cardiac and lung examinations. Ultrasound also was useful for guidance during procedural applications, and for aiding in the diagnosis of parasitic diseases.

Shorter M, Macias D. Portable handheld ultrasound in austere environments: use in the Haiti disaster. Prehosp Disaster Med. 2012;27(2):1-6.

Keywords

abdominal ultrasoundaustere environmentdiagnostic equipmentdisaster responseGheskio Field ClinicHaitihandheld ultrasoundhumanitarian assistancenatural disasterNew Mexico Disaster Medical Assistance Teamportable ultrasoundprocedural ultrasoundqualitative studytriagerelief workultrasonographyundifferentiated hypotension
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 2 , April 2012 , pp. 172 - 177
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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