Who Says You can't go FAST at Night? Use of a Novel Ultrasound-Capable Night Vision Device for Prehospital Medical Personnel to Identify Noncompressible Truncal Hemorrhage.

black out conditions focused assessment with sonography for trauma forward deployed intra-abdominal hemorrhage night vision googles

Journal

Surgical innovation
ISSN: 1553-3514
Titre abrégé: Surg Innov
Pays: United States
ID NLM: 101233809

Informations de publication

Date de publication:
16 Aug 2024
Historique:
medline: 17 8 2024
pubmed: 17 8 2024
entrez: 16 8 2024
Statut: aheadofprint

Résumé

Early detection of abdominal hemorrhage via ultrasound has life-saving implications for military and civilian trauma. However, strict adherence to light discipline may prohibit the use of ultrasound devices in the deployed setting. Additionally, current night vision devices remain noncompatible with ultrasound technology. This study sought to assess an innovative night vision device with ultrasound capable picture-in-picture display via a intraabdominal hemorrhage model to identify noncompressible truncal hemorrhage in blackout conditions. 8 post mortem fetal porcine specimens were used and divided into 2 groups: intrabdominal hemorrhage (n = 4) vs no hemorrhage (n = 4). Intrabdominal hemorrhage was modeled via direct injection of 200 mL of normal saline into the peritoneal cavity. Under blackout conditions, 5 participants performed a focused assessment with sonography for trauma (FAST) exam on each model using the prototype ultrasound-capable night vision device. Of the 40 FAST exams performed, 95% (N = 38) resulted in the correct identification of intraabdominal hemorrhage. Of the incorrectly identified exams, both were false positives resulting in a 100% sensitivity, 90% specificity, 91% positive predictive value, and a 100% negative predictive value. All participants noted the novel device was easy to use and provided superior visualization for performing FAST exams under blackout conditions. The ultrasound-enabled night vision prototype demonstrated promising results in identifying noncompressible truncal hemorrhage while maintaining strict light discipline in blackout conditions. Further research efforts should be directed at assessing the ability of providers to perform procedures in blackout conditions using the ultrasound-enabled prototype night vision device.

Sections du résumé

BACKGROUND BACKGROUND
Early detection of abdominal hemorrhage via ultrasound has life-saving implications for military and civilian trauma. However, strict adherence to light discipline may prohibit the use of ultrasound devices in the deployed setting. Additionally, current night vision devices remain noncompatible with ultrasound technology. This study sought to assess an innovative night vision device with ultrasound capable picture-in-picture display via a intraabdominal hemorrhage model to identify noncompressible truncal hemorrhage in blackout conditions.
METHODS METHODS
8 post mortem fetal porcine specimens were used and divided into 2 groups: intrabdominal hemorrhage (n = 4) vs no hemorrhage (n = 4). Intrabdominal hemorrhage was modeled via direct injection of 200 mL of normal saline into the peritoneal cavity. Under blackout conditions, 5 participants performed a focused assessment with sonography for trauma (FAST) exam on each model using the prototype ultrasound-capable night vision device.
RESULTS RESULTS
Of the 40 FAST exams performed, 95% (N = 38) resulted in the correct identification of intraabdominal hemorrhage. Of the incorrectly identified exams, both were false positives resulting in a 100% sensitivity, 90% specificity, 91% positive predictive value, and a 100% negative predictive value. All participants noted the novel device was easy to use and provided superior visualization for performing FAST exams under blackout conditions.
CONCLUSION CONCLUSIONS
The ultrasound-enabled night vision prototype demonstrated promising results in identifying noncompressible truncal hemorrhage while maintaining strict light discipline in blackout conditions. Further research efforts should be directed at assessing the ability of providers to perform procedures in blackout conditions using the ultrasound-enabled prototype night vision device.

Identifiants

pubmed: 39151929
doi: 10.1177/15533506241275288
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15533506241275288

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Y.L. is a Unify Medical Shareholders. The additional authors report no relevant conflicts of interest. The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Defense Health Agency, the Department of Defense, or the U.S. Government.

Auteurs

James Williams (J)

Madigan Army Medical Center, Tacoma, WA, USA.

Daniel T Lammers (DT)

University of Alabama Birmingham, Birmingham, AL, USA.

Andrew D Francis (AD)

Madigan Army Medical Center, Tacoma, WA, USA.

Beau J Prey (BJ)

Madigan Army Medical Center, Tacoma, WA, USA.

Luke I Pumiglia (LI)

Madigan Army Medical Center, Tacoma, WA, USA.

Matthew J Eckert (MJ)

University of North Carolina Chapel Hill, Chapel Hill, NC USA.

Yang Liu (Y)

Unify Medical Inc, Cleveland, OH, USA.
University of Iowa, Iowa City, IA, USA.

Jason R Bingham (JR)

Madigan Army Medical Center, Tacoma, WA, USA.

John M McClellan (JM)

University of North Carolina Chapel Hill, Chapel Hill, NC USA.

Classifications MeSH