Air Medical Ultrasound: Looking Back to See What We Have Learned for the Future.

OBJECTIVE

This study attempts to replicate data from a similar study performed 5 years ago by comparing point-of-care (POCUS) extended focused abdominal sonography in trauma (eFAST) examinations performed by an air medical flight crew with those performed by a trauma team at a level 1 trauma center.

METHODS

This prospective observational study evaluated 174 trauma patients over a 12-month period in southeastern Virginia and northeastern North Carolina.

RESULTS

For 101 trauma patients who had a POCUS evaluation completed by the flight crews, a positive predictive value of 100% was obtained with a negative predictive value of 96.63% for pneumothorax, hemothorax, and free abdominal fluid. This showed no significant difference in that of the trauma team's POCUS studies or that of the data from the 2017 study. Early recognition of life-threatening injury continues to be a priority during the assessment of traumatically injured patients. In conjunction with a thorough history and physical examination, POCUS is a very effective method to identify these potentially devastating injuries, especially in the air medical community. When we compared this study's results with those of our study from 2017, the data were very similar, showing that flight crews can conduct POCUS examinations effectively in the austere prehospital environment.

CONCLUSION

By replicating this study, we have shown the validity and continued quality, accuracy, and benefits of the POCUS eFAST examination of trauma patients in the air medical environment. The validity of our previous and now current research suggests that some current standard trauma protocol revisions are indicated (ie, the initiation of air medical trauma resuscitation with blood products, preferably whole blood, and the transport of critically injured patients with a positive POCUS examination for free abdominal fluid directly to the operating room should be closely evaluated).