title: Prehospital chest ultrasound by a dutch helicopter emergency medical service.
abstract: BACKGROUND
  Due to advancements in technology, the use of a portable ultrasound (US) machine in the out-of-hospital setting is increasingly feasible. It has diagnostic and therapeutic advantages and may improve the management and treatment of patients. It can be used in-flight and can be easily taught to flight clinicians who have little previous experience with this modality.
  
  
  OBJECTIVE
  The goal of this study was to evaluate the impact of ultrasound chest examinations on the care of patients treated by a Helicopter Emergency Medical Service (HEMS).
  
  
  METHODS
  Since 2007, portable US has been used by the HEMS of Nijmegen, The Netherlands. Data on every air medical flight are routinely collected in a database. Every portable US examination of the chest performed between 2007 and 2010 was reviewed for this study. Data on patient characteristics, properties of US examinations, US diagnoses, and impact on medical treatment were collected and analyzed.
  
  
  RESULTS
  Of a total of 2572 patients, 326 portable US examinations of the chest were performed on 281 (11%) patients. The mean duration of a portable US examination was 2.77 (SD 1.30) min, and the duration decreased over time. After the US examination, the plan for treatment changed in 60 (21%) patients. In 10 patients (4%) the plan to place a chest tube was abandoned. In 10 patients (4%) the initially selected destination for definitive care changed, and it changed to a lower-level hospital more often than to a higher-level one. In 9 patients (3%), cardiopulmonary resuscitation was stopped and in 31 patients there were other changes.
  
  
  CONCLUSIONS
  Out-of-hospital US examinations can alter and improve treatment decisions and destinations for definitive care.
authors: Department of Anesthesiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: Rein
authors: R
authors: Ketelaars
authors: Nico
authors: N
authors: Hoogerwerf
authors: Gert Jan
authors: GJ
authors: Scheffer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011030:Pneumothorax / Q000000981:diagnostic imaging; D019095:Point-of-Care Systems / Q000592:standards / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult