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World J Orthop. 2010 Nov 18;1(1):10-9. doi: 10.5312/wjo.v1.i1.10.

Portable ultrasonography in mass casualty incidents: The CAVEAT examination.

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1
Stanislaw Peter Stawicki, James M Howard, Melissa L Whitmill, Department of Surgery, Division of Critical Care, Trauma, and Burn, The Ohio State University Medical Center, Columbus, OH 43210, United States.

Abstract

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings.

KEYWORDS:

Chest, abdomen, vena cava, and extremities for acute triage; Disaster; Field triage; Focused Assessment with Sonography in Trauma; Mass casualty incident; Pre-hospital care; Ultrasonography

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