Posted by: Joseph Cuthbertson; 20 June 2016; 12:15 pm
Post written by: Dr. Sanjeev Bhoi, All India Institute of Medical Sciences (AIMMS)
Point of care sonography (POCS) done by clinicians has become popular over the past two decades1. Its use has been described as an adjunct to physical examination during resuscitation 2.Ultrasound has also been shown to be useful to emergency care providers with differing levels of training, background, and clinical focus such as trauma and emergency care 3. The Focused Assessment with Sonography in Trauma (FAST) examination has become the standard of care for the diagnosis of post-traumatic pericardial tamponade and hemoperitoneum 4. POCS is also useful in diagnosis of chest, extremity trauma, evaluation of shock states and intravascular volume depletion 4,5,6,7.
Disasters are situations which demands quick triage of large numbers of injured patients, especially in a resource limited setting 8. An immediately deployable, flexible and resource-sparing emergency medical response is key to improve survival during disaster. In disasters, the benefit from early intervention to the injured is often undermined by relative lack of healthcare personnel, a chaotic environment, and deficient stable social infrastructure 6,7.This limits the availability of most modern diagnostic tools, especially imaging modalities, because they are resource intensive and require a high degree of infrastructural integrity. Thus, in a disaster, responders may be forced to rely only on history and clinical examination which is relatively time-consuming and often inaccurate approach in this setting.
Modern ultrasound machines are portable, robust, easy to use, and inexpensive. These advances allow ultrasound to be brought to the patients to acquire diagnostic information in real time. In addition, literature describes its use in remote, austere, and resource-poor settings, including outer space, high altitudes and combat settings9. It can address triage, resuscitation and critical treatment decisions during the disaster 10,11,12,13. Virtual technology such as telemedicine can be integrated with the POCS to make critical management decisions in the field. These qualities of point of care ultrasound makes it uniquely suited for deployment in the care of patients in the setting of a disaster.