Change in Differential Diagnosis and Patient Management With the Use of Portable Ultrasound in a Remote Setting☆

作者：Michael Blaivas, Walter Kühn, Bradford Zahner Reynolds, Larry Brannam · 发表于：Wilderness and Environmental Medicine · 年份：2005 · DOI：10.1580/1080-6032(2005)16[38:ciddap]2.0.co;2 · 被引用次数：89 · 研究领域：Ultrasound in Clinical Applications、Amoebic Infections and Treatments、Appendicitis Diagnosis and Management

OBJECTIVE: Physicians practicing in remote areas are typically limited in their choice of diagnostic tools. The goal of this study was to determine whether the use of a portable ultrasound (US) device on selected patients in a remote setting would alter physician diagnosis and management. METHODS: This was a prospective observational study of the affects of US on physician decision making deep in the Amazon jungle. A battery-operated Sonosite 180 Plus with 2 interchangeable transducers (4-7-MHz broadband intercavitary transducer and 2-5-MHz broadband abdominal transducer) was used. The patient population consisted of local tribal people. Two of the physicians on the team performed all US examinations. Team physicians requesting US examinations filled out a survey before and after the US examination. Before the US, the referring physician filled out a survey describing the patient's initial complaint, pertinent past medical history and physical findings, and an initial (pre-US) differential diagnosis and planned treatment with expected disposition. After the results of the US were reviewed with the referring physicians, the doctors were asked to fill out the remainder of the survey, allowing comparison of pre- and post-US differential diagnosis, treatment plan, and disposition. RESULTS: A total of 25 US studies were performed during this study (1 trauma US scan, 6 hepatobiliary studies, 5 transabdominal pelvic scans, 7 transvaginal pelvic studies, 3 renal studies, and 3 abdomi...