Space Medicine: Non-physician Thoracic Ultrasound For Trauma

Pneumothorax (PTX) represents a significant portion of thoracic trauma on earth and on orbit during prolonged spaceflight. Physician performed thoracic ultrasound is of proven efficacy; however the ability of non-physicians to utilize this modality is unknown. The authors evaluated the ability of non-physicians to perform thoracic ultrasound in ground (1g) and zero gravity (0g) conditions. A swine model of pneumothorax (100-500 cc air aliquots per hemi-thorax) was used in ground (n = 5) and 0g (n = 4) parabolic flights. Non-physician operators were remotely guided to perform thoracic ultrasound using visual and verbal cues. All scans were completed in less than 30 seconds. This study represents the first demonstration of successful utilization of remote guidance to obtain thoracic ultrasound images of diagnostic quality by non-physician operators. The technique of remote expert guidance can significantly enhance the medical capabilities during exploratory class spaceflight, in rural settings, third world areas, disaster sights, or emergency medicine environments where there is limited or delayed availability of a physician at the site.