Utility of Point of Care Ultrasound in Humanitarian Assistance Missions.

Abstract

Point of care ultrasound (POCUS) is increasingly used in primary care in the USA and has been shown to provide significant benefit to care in deployed military settings and during disaster relief efforts. It is less studied as a tool during humanitarian assistance missions. We sought to determine the utility of POCUS in a humanitarian assistance setting during the February 2019 joint U.S.-Brazilian hospital assistance mission aboard the Hospitalar Assistance Ship Carlos Chagas along the Madeira River in the Brazilian Amazon. Point of care ultrasound was offered as a diagnostic modality to primary care physicians during the course of a month-long mission. A handheld IVIZ ultrasound machine was loaned for use during this mission by Sonosite. A P21v phased array (5-1 MHz) or an L38v linear (10-5 MHz) transducer was used for scanning. Requests for POCUS examinations, their findings, and changes in patient management were recorded. Point of care ultrasound examinations were requested and performed in 24 of 814 (3%) outpatient primary care visits. Ten of these studies (42% of POCUS examinations, 1.2% of all patient visits) directed patient management decisions, in each case preventing unnecessary referral. In this austere setting, POCUS proved to be an inexpensive, effective tool at preventing unnecessary referrals. Future medical humanitarian assistance missions may likewise find POCUS to be a primary care force-multiplier.