title: Near-Infrared Spectroscopy: A Promising Prehospital Tool for Management of Traumatic Brain Injury.
abstract: Introduction Early identification of traumatic brain injury (TBI) is essential. Near-infrared spectroscopy (NIRS) can be used in prehospital settings for non-invasive monitoring and the diagnosis of patients who may require surgical intervention.
  
  
  METHODS
  The handheld NIRS Infrascanner (InfraScan Inc.; Philadelphia, Pennsylvania USA) uses eight symmetrical scan points to detect intracranial bleeding. A scanner was tested in a physician-staffed helicopter Emergency Medical Service (HEMS). The results were compared with those obtained using in-hospital computed tomography (CT) scans. Scan time, ease-of-use, and change in treatment were scored.
  
  
  RESULTS
  A total of 25 patients were included. Complete scans were performed in 60% of patients. In 15 patients, the scan was abnormal, and in one patient, the scan resulted in a treatment change. Compared with the results of CT scanning, the Infrascanner obtained a sensitivity of 93.3% and a specificity of 78.6%. Most patients had severe TBI with indication for transport to a trauma center prior to scanning. In one patient, the scan resulted in a treatment change. Evaluation of patients with less severe TBI is needed to support the usefulness of the Infrascanner as a prehospital triage tool.
  
  
  CONCLUSIONS
  Promising results were obtained using the InfraScan NIRS device in prehospital screening for intracranial hematomas in TBI patients. High sensitivity and good specificity were found. Further research is necessary to determine the beneficial effects of enhanced prehospital screening on triage, survival, and quality of life in TBI patients. Peters J , Van Wageningen B , Hoogerwerf N , Tan E . Near-infrared spectroscopy: a promising prehospital tool for management of traumatic brain injury. Prehosp Disaster Med. 2017;32(4):414-418.
authors.affiliation: 1Department of Trauma Surgery,Radboud University Medical Center Nijmegen,Geert Grooteplein Zuid 10,6525 GAThe Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Peters
authors.affiliation: 1Department of Trauma Surgery,Radboud University Medical Center Nijmegen,Geert Grooteplein Zuid 10,6525 GAThe Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Van Wageningen
authors.affiliation: 2Helicopter Emergency Medical Service,Radboud University Medical Center Nijmegen,Geert Grooteplein Zuid 10,6525 GAThe Netherlands.
authors.forename: Nico
authors.initials: N
authors.lastname: Hoogerwerf
authors.affiliation: 1Department of Trauma Surgery,Radboud University Medical Center Nijmegen,Geert Grooteplein Zuid 10,6525 GAThe Netherlands.
authors.forename: Edward
authors.initials: E
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords:  CT computed tomography;  EMS Emergency Medical Service;  GCS Glasgow Coma Score;  HEMS helicopter Emergency Medical Service;  NIRS near-infrared spectroscopy;  TBI traumatic brain injury; diagnostic equipment; infrared spectrophotometry; prehospital emergency care; traumatic brain injury