Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol.

Chinwe Ogedegbe,Joseph Feldman,William F Chaplin,Herman Morchel,Vikki Hazelwood

doi:10.1186/1471-227x-12-19

Abstract

BackgroundDespite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS) system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1) real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2) Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED.MethodsStudy participants are three healthy volunteers (one each with normal, overweight and obese BMI category). The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite) interfaced with a portable broadcast unit (by Live-U). Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators) using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS).DiscussionFindings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting.

Highlights

Despite the use of extended-Focused Assessment with Sonography in Trauma (e-FAST) in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted
The goal of this study is to develop a novel telesonography (TS) system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the emergency department (ED)
We hypothesize that: (1) real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2) Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED

Summary

Introduction

Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The widely adopted Focused Assessment with Sonography for Trauma (FAST) has reduced the time-to-surgery by training of ED physicians to accurately diagnose acute abdominal injuries, often a common cause of death in patients who present to the ED with acute trauma [11,12,13,14,15,16,17,18]. FAST is widely employed in most tertiary EDs across the country, its ability to reduce the timeto- diagnosis is still significantly limited [19,20,21,22] This is largely due to the paucity of specialists trained in the use of FAST and the lack of trauma expertise in community-based hospital EDs, where majority of patients with acute trauma receive care. This ‘downtime’ provides an opportunity to reduce the time-to-diagnosis during transportation from the prehospital setting by paramedics to the ED

Objectives

Methods

Conclusion