Diagnostic ultrasound examinations during evacuation of urgent patients by ambulance helicopters: literature review

Abstract

Relevance. The use of ultrasound diagnostics at the place of providing medical care to an urgent patient is one of the promising directions in the development of emergency medicine. At the same time, of particular interest is the possibility of using diagnostic ultrasound in an ambulance helicopter, given the lack of clear algorithms and standards for its application, as well as the limited number of publications on this problem.Intention. Analysis of publications on the use of urgent ultrasound examination in an ambulance helicopter.Methodology. A search was made for scientific publications on the topic on the electronic resource PubMed, in the Google Scholar search system for the period from 2000 to 2021.Results and discussion. The main algorithms used for ultrasound diagnostics of an urgent patient in an ambulance helicopter are Focused Assessment with Sonography for Trauma (FAST), point-of-care ultrasound (POCUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ), prehospital ultrasonography (PHUS), etc. They help exclude damage to vital organs and emergency pathology – pneumo- and hemothorax, hemoperitoneum, hemopericardium, large fractures and others that affect the tactics of treatment and patient routing; there is also the possibility of ultrasound navigation for a number of medical and diagnostic procedures. According to the results of published studies and clinical observations, prehospital ultrasound examination of urgent patients is successfully used during medical evacuation by an ambulance helicopter in emergency medical services in many countries of the world (both by doctors and other medical personnel), making it possible to diagnose a number of lifethreatening conditions with a fairly high accuracy, without loss of time and without damage to patient’s health. An important aspect of the successful application of the method during flight is the training of qualified personnel. The prospects for the development of the method are the development of more advanced ultrasound scanners and sensors adapted to flight conditions, as well as the use of telemedicine technologies for remote analysis of ultrasound images.Conclusion. The experience of using prehospital diagnostic ultrasound in an ambulance helicopter requires further data accumulation and systematic analysis, but the method is already undoubtedly useful in determining the tactics of treatment and the route of hospitalization of urgent patients with acute trauma and a number of other pathological conditions.