title: The utility of handheld ultrasound in an austere medical setting in Guatemala after a natural disaster.
abstract: OBJECTIVE
  To identify equipment needs, utility, clinical applications, and acuity of diagnoses made by hand-carried ultrasound (HCU) after a natural disaster.
  
  
  METHODS
  An HCU with four probes (curved array, linear array, phased array, and endocavitary) was taken to the site of a natural disaster in Guatemala as part of the relief effort after mudslides killed approximately 1,000 people. Ultrasound (US) scans were classified by transducer type, anatomic region, presenting complaint, and therapeutic urgency of treatment.
  
  
  RESULTS
  Ninety-nine patients received 137 US: 58 pelvic, 34 right upper quadrant, 23 renal, six other abdominal, five orthopedic, four cardiac, three pleura and lung, three soft tissue, and one focused assessment by sonography in trauma. Acuity of presenting illness: 23 percent <24 hours, 15 percent 1-14 days, 44 percent >14 days. Eighteen percent were performed in prenatal clinic. Results of US ruled in 12 percent with an emergent problem and excluded disease in 42 percent. In 14 percent, US diagnosed a problem needing flu in <2 weeks, and 32 percent with a problem needing long-term observation. Transducer utilization was general purpose curved array 88 percent, linear array 10 percent, endocavitary 8 percent, and phased array 4 percent.
  
  
  CONCLUSIONS
  HCU has a range of applications in an austere medical setting after a natural disaster. Most can be dealt with using a single transducer.
authors.affiliation: Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Dean
authors.forename: Bon S
authors.initials: BS
authors.lastname: Ku
authors.forename: Eli M
authors.initials: EM
authors.lastname: Zeserson
mesh_terms: D015331:Cohort Studies; D004190:Disasters; D005260:Female; D006166:Guatemala; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000209:etiology; D012066:Relief Work; D012189:Retrospective Studies; D014463:Ultrasonography / Q000295:instrumentation* / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000209:etiology