Potential of a hand-held ultrasound in assessment of the injured patient

Abstract

Current studies indicate that portable ultrasound used by trained trauma surgeons in the emergency room can be performed using the focused abdominal sonogram for trauma technique in approximately 2 minutes to evaluate patients with blunt torso trauma. It has been shown to be as accurate as DPL and computed tomography (CT) in the detection of hemoperitoneum following abdominal trauma. It is also very accurate in detecting pericardial fluid and may have a role in the evaluation of penetrating injuries of the thorax, either from stab or gunshot wounds. The examination is best performed early on in the secondary survey of the injured patient. Miniaturization and hand-held ultrasound units are on the horizon. The faculty of the University of Washington in Seattle in conjunction with the Advanced Technology Laboratories in Seattle and the Advanced Research Project Agency of the Department of Defense are producing a battlefield hand-held ultrasound with the ultimate goal to have an ultrasound unit that will fit in the trauma surgeon's pocket. With the use of this new technology, the potential for early diagnosis of victims of trauma and prompt treatment is at hand. One of the greatest challenges remaining is that of training surgeons in the use of ultrasound. The author's experience in conducting ultrasound courses for surgeons at the Uniformed Services University of the Health Sciences is described.