Aeromedical trauma sonography by flight crews with a miniature ultrasound unit

While ultrasound has become an established diagnostic modality in trauma care, no study has evaluated its use in the prehospital setting.

To examine the use of the focused abdominal sonography for trauma (FAST) exam in the prehospital setting.

After a three-hour training session in the FAST exam, the nonphysician flight team of an emergency medical services (EMS) helicopter program attempted a FAST exam on trauma patients to determine the feasibility of such an intervention.

The majority (83%) of the 71 patients entered suffered blunt trauma. FAST exams could not be performed in 34 patients (48%) due to insufficient time (67%), inadequate patient access, or combativeness. Technical difficulties (difficult screen visualization due to ambient lighting, battery failure, and machine malfunction) prevented scanning in seven (19%) of the 37 in whom it was attempted. In those in whom scanning was successful, the pelvic view was most commonly obtained followed by the right upper quadrant (RUQ) and left upper quadrant (LUQ).

Significant advances in training, technology, and/or patient access will be necessary for aeromedical FAST to be feasible.