title: Portable ultrasonography in mass casualty incidents: The CAVEAT examination.
abstract: Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings.
authors.affiliation: Stanislaw Peter Stawicki, James M Howard, Melissa L Whitmill, Department of Surgery, Division of Critical Care, Trauma, and Burn, The Ohio State University Medical Center, Columbus, OH 43210, United States.
authors.forename: Stanislaw Peter
authors.initials: SP
authors.lastname: Stawicki
authors.forename: James M
authors.initials: JM
authors.lastname: Howard
authors.forename: John P
authors.initials: JP
authors.lastname: Pryor
authors.forename: David P
authors.initials: DP
authors.lastname: Bahner
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Whitmill
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Dean