Austere, Pre-Transport, Qualitative Clinical Testing
Abstract
It is not clear how well present or near-term medical technologies may align with critical physiological supportive measures that would increase early caregiver prognostic confidence at point-of-care. In this study, we sought to address the following clinical question: What light-weight, compact, easily usable prehospital testing can be used to assist medical personnel and combat medics in determining triage, the need for rapid evacuation, the need for blood product administration, and other medical interventions? The purpose of this project was to 1) conduct a thorough scoping review and a scientific market survey of present and near-term diagnostic technologies for adaptation to rigorous care environments and 2) evaluate the clinical priorities of candidate measures for various trauma and injury scenarios. Methods: We gathered information about present and near term technologies in several ways. Team members who attended professional meetings visited vendors to observe technology demonstrations. Further, a computer-aided search of MEDLINE, the Cochrane Database of Systematic Reviews, and EMBASE was conducted through the OVID SP Web site. We queried PubMed using the same strategy. In addition, a search of Google scholar was conducted. We selected two technologies on which to conduct a thorough review of available evidence: point-of-care ultrasound (POCUS), and noninvasive hemoglobin (NIHB) monitoring. Conclusions: The body of evidence related to the use of POCUS by military medics is limited, but does provide proof of concept. More research with larger sample sizes and evaluation of patient outcomes is needed. The value of POCUS in austere environments has been demonstrated and could significantly impact care in the prehospital combat setting. Most of the evidence related to the clinical accuracy of NIHb monitoring does not support its utility in combat casualty care. Studies recommend caution when using results for clinical decision-making.
Document Details
- Document Type
- Technical Report
- Publication Date
- Feb 22, 2021
- Accession Number
- AD1142135
Entities
People
- Darren S. Baldwin
- Joseph K Maddry
- Shelia Savell
Organizations
- 59th Medical Wing