The utility of handheld ultrasound in an austere medical setting in Guatemala after a natural disaster

Abstract

Objective: To identify equipment needs, utility, clinical applications, and acuity of diagnoses made by hand-carried ultrasound (HCU) after a natural disaster.Methods: An HCU with four probes (curved array, linear array, phased array, and endocavitary) was taken to the site of a natural disaster in Guatemala as part of the relief effort after mudslides killed approximately 1,000 people. Ultrasound (US) scans were classified by transducer type, anatomic region, presenting complaint, and therapeutic urgency of treatment.Results: Ninety-nine patients received 137 US: 58 pelvic, 34 right upper quadrant, 23 renal, six other abdominal, five orthopedic, four cardiac, three pleura and lung, three soft tissue, and one focused assessment by sonography in trauma. Acuity of presenting illness: 23 percent 24 hours, 15 percent 1-14 days, 44 percent 14 days. Eighteen percent were performed in prenatal clinic. Results of US ruled in 12 percent with an emergent problem and excluded disease in 42 percent. In 14 percent, US diagnosed a problem needing f/u in 2 weeks, and 32 percent with a problem needing long-term observation. Transducer utilization was general purpose curved array 88 percent, linear array 10 percent, endocavitary 8 percent, and phased array 4 percent.Conclusions: HCU has a range of applications in an austere medical setting after a natural disaster. Most can be dealt with using a single transducer.