title: Feasibility of real-time echocardiographic evaluation during patient transport.
abstract: Echocardiography is a key diagnostic tool in evaluating patients with cardiac emergencies and chest trauma. The lack of qualified real-time interpretation limits its use by emergency first responders. Early diagnosis of cardiac emergencies has the potential to facilitate triage and medical intervention to improve outcomes. We investigated the feasibility of remote, real-time interpretation of echocardiograms during patient transport. Echocardiograms using a hand-carried ultrasound device were transmitted from an ambulance in transit to a tertiary care facility using a distributed mobile local area network. Transmitted studies were reviewed by a cardiologist for ability to interpret predefined features. Transmission quality and reliability were assessed. Echocardiographic images were successfully transmitted greater than 88% of transport time. The evaluation of left-ventricular size and function, and presence of pericardial effusion were greater than 90% concordant, but only 66% of all echocardiographic features were concordant. Most transmission losses were brief (<or=10 seconds) with little impact on interpretability. Wireless infrastructures in metropolitan areas provide the ability for real-time transmission of echocardiograms during patient transport of adequate quality for accurate interpretation.
authors.affiliation: Cardiology Department, Brooke Army Medical Center, and Southwest Research Institute, Houston, TX 78234, USA. Paul.Garrett@amedd.army.mil
authors.forename: Paul D
authors.initials: PD
authors.lastname: Garrett
authors.forename: Sheri Y N
authors.initials: SY
authors.lastname: Boyd
authors.forename: Terry D
authors.initials: TD
authors.lastname: Bauch
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Rubal
authors.forename: James R
authors.initials: JR
authors.lastname: Bulgrin
authors.forename: E Sterling
authors.initials: ES
authors.lastname: Kinkler
mesh_terms: D000552:Ambulances; D004452:Echocardiography; D005240:Feasibility Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D011237:Predictive Value of Tests; D011897:Random Allocation; D015203:Reproducibility of Results; D013997:Time Factors; D014187:Transportation of Patients; D016276:Ventricular Function; D016277:Ventricular Function, Left / Q000502:physiology