救护车直升机疏散急诊患者时的超声诊断检查:文献回顾

S. A. Gumenyuk, S. Aleksanin, A. M. Schikota, V. Yarema, I. Pogonchenkova
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引用次数: 0

摘要

的相关性。超声诊断在为急症患者提供医疗服务的地方的应用是急诊医学发展的一个有前途的方向。与此同时,特别令人感兴趣的是在救护直升机上使用诊断超声的可能性,因为它的应用缺乏明确的算法和标准,而且关于这个问题的出版物数量有限。救护直升机上使用紧急超声检查的出版物分析。方法学。在谷歌学术搜索系统中检索了2000年至2021年期间在电子资源PubMed上关于该主题的科学出版物。结果和讨论。用于救护直升机上急诊患者超声诊断的主要算法有创伤超声集中评估(FAST)、护理点超声(POCUS)、休克快速超声(RUSH)、急诊床边肺超声(BLUЕ)、院前超声(PHUS)等。它们有助于排除对重要器官的损害和紧急病理——肺炎——以及胸血、腹膜血、心包血、大骨折和其他影响治疗策略和病人路线的因素;在一些医疗和诊断程序中,超声波导航也是可能的。根据已发表的研究和临床观察的结果,在世界上许多国家的紧急医疗服务中,救护车直升机(医生和其他医务人员)在医疗后送期间成功地使用了对紧急病人的院前超声检查,从而能够以相当高的准确性诊断出一些危及生命的疾病,而不浪费时间,也不损害病人的健康。在飞行中成功应用该方法的一个重要方面是培训合格人员。该方法的发展前景是开发更先进的适应飞行条件的超声扫描仪和传感器,以及使用远程医疗技术对超声图像进行远程分析。在救护直升机上使用院前超声诊断的经验需要进一步的数据积累和系统分析,但该方法在确定急性创伤和许多其他病理状况的紧急患者的治疗策略和住院路线方面无疑是有用的。
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Diagnostic ultrasound examinations during evacuation of urgent patients by ambulance helicopters: literature review
Relevance. The use of ultrasound diagnostics at the place of providing medical care to an urgent patient is one of the promising directions in the development of emergency medicine. At the same time, of particular interest is the possibility of using diagnostic ultrasound in an ambulance helicopter, given the lack of clear algorithms and standards for its application, as well as the limited number of publications on this problem.Intention. Analysis of publications on the use of urgent ultrasound examination in an ambulance helicopter.Methodology. A search was made for scientific publications on the topic on the electronic resource PubMed, in the Google Scholar search system for the period from 2000 to 2021.Results and discussion. The main algorithms used for ultrasound diagnostics of an urgent patient in an ambulance helicopter are Focused Assessment with Sonography for Trauma (FAST), point-of-care ultrasound (POCUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ), prehospital ultrasonography (PHUS), etc. They help exclude damage to vital organs and emergency pathology – pneumo- and hemothorax, hemoperitoneum, hemopericardium, large fractures and others that affect the tactics of treatment and patient routing; there is also the possibility of ultrasound navigation for a number of medical and diagnostic procedures. According to the results of published studies and clinical observations, prehospital ultrasound examination of urgent patients is successfully used during medical evacuation by an ambulance helicopter in emergency medical services in many countries of the world (both by doctors and other medical personnel), making it possible to diagnose a number of lifethreatening conditions with a fairly high accuracy, without loss of time and without damage to patient’s health. An important aspect of the successful application of the method during flight is the training of qualified personnel. The prospects for the development of the method are the development of more advanced ultrasound scanners and sensors adapted to flight conditions, as well as the use of telemedicine technologies for remote analysis of ultrasound images.Conclusion. The experience of using prehospital diagnostic ultrasound in an ambulance helicopter requires further data accumulation and systematic analysis, but the method is already undoubtedly useful in determining the tactics of treatment and the route of hospitalization of urgent patients with acute trauma and a number of other pathological conditions.
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