(Check out the incredible follow-up to this story here)
When a 65-year-old man collapsed in a rural hospital bathroom following a night of severe abdominal pain, nausea, vomiting and ultimately cardiac arrest, STARS was called.
Medical staff knew he needed urgent care at a larger hospital.
Within minutes of loading the patient into the helicopter and taking off, STARS nurse Rene Chapman reached for a portable ultrasound machine and placed the probe on the patient’s abdomen. What he saw on the screen satisfied his suspicion.
“We saw a large aortic aneurysm,” said Chapman. “The big blood vessel from that runs from your heart to the lower part of your body was three times larger than it should have been.”
While the crew administered blood products and continued to treat the patient, the STARS Emergency Link Centre contacted the STARS transport physician, as well as the vascular surgeon on call, about the new information that the ultrasound provided. This patient would need urgent surgery to repair his aorta.
“By the time we got to hospital they had an operating room and team prepped and waiting for us and the vascular surgeon met us at the doors,” said Chapman, adding because we were able to confirm the abnormal aorta on ultrasound and get those images to the surgeon, the teams were preparing for urgent surgery well before we arrived.
“After a successful surgical repair of the ruptured aneurysm, the patient improved quickly and was well enough to be discharged home five days later,” said Chapman.
While bedside ultrasound has long been used successfully in emergency departments by physicians, it’s only recently been used in the pre-hospital, flight environment, said STARS medical director, Saskatoon and transport physician, Dr. John Froh. In an effort to learn more, Froh, in partnership with the University of Saskatchewan, has launched a study of all critical care air ambulance services (fixed or rotary wing) to find out who is utilizing pre-hospital ultrasound in Canada.
He notes that the aim of the study is to learn more about the successes and limitations of the equipment in the air.
“One of our mandates is to provide cutting edge and innovative care,” said Froh. “Our understanding is this is rather unique in Canada and we wanted to collect data to support or refute that impression.”
Thanks to our generous donors, all STARS helicopters are equipped with ultrasound machines which are currently used by transport physicians when they are on the mission as well as a handful of certified air medical crew. On the heels of a recent study by STARS on pre-hospital ultrasound use, we have launched a pilot project to measure patient outcomes when ultrasound is used in flight.
For Chapman, bringing ultrasound to these sick patients offers STARS transport teams another valuable tool to help guide care.
“Critically ill and injured patients display a variety of symptoms and it can sometimes be challenging to differentiate the cause of these illnesses, especially when you are in a rural hospital or at a scene call where there is limited help and limited diagnostics,” said Chapman.