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Prospective Evaluation of Point-of-Care Ultrasound at a Remote, Multi-Day Music Festival

Published online by Cambridge University Press:  01 October 2018

Ross Prager ,
Colin Sedgwick ,
Adam Lund ,
Daniel Kim Open the ORCID record for Daniel Kim [Opens in a new window] ,
Ben Ho ,
Maja Stachura  and
Samuel Gutman
Ross Prager*
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada
Colin Sedgwick
Affiliation:
MD Undergraduate Program, University of British Columbia, Vancouver, British Columbia, Canada
Adam Lund
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada
Daniel Kim
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
Ben Ho
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada
Maja Stachura
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
Samuel Gutman
Affiliation:
University of British Columbia, Vancouver, British Columbia, Canada
*
Correspondence: Ross T. Prager, MD c/o Dr. Samuel Gutman Lions Gate Hospital Emergency Department 231 15th St E North Vancouver, British Columbia, Canada, V7L 2L7 E-mail: r.thomas.p@hotmail.com
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Abstract

Introduction

Point-of-Care Ultrasound (POCUS) has become an important diagnostic tool for hospital-based clinicians. This study assesses the role of POCUS at Pemberton Music Festival 2016 (Pemberton, British Columbia [BC], Canada), a remote mass gathering where physicians face limited resources, complex disposition decisions, and a dynamic clinical environment.

Objectives

This study prospectively evaluated the impact of POCUS on patient diagnosis, management, and disposition based on the self-report of the study physicians. The authors hypothesized that having ultrasound available for use would aid in diagnostic and management decisions and would reduce the need to transfer patients off-site to other health care facilities, reducing impact on the acute health services in the host community.

Methods

A handheld ultrasound was available for use by physicians in the main medical tent. All participating physicians self-reported their training and comfort using POCUS. After each POCUS scan, physicians completed a survey and recorded the indication for use, scans performed, and impact on patient diagnosis, management, and disposition.

Results

In total, POCUS was used on 28 of the 686 patients treated in the main medical tent; POCUS was reported to narrow the differential diagnosis in 64% of cases and altered the working diagnosis in 21% of cases. Its use changed the management plan in 39% of patients. Its use was reported to reduce the burden on broader health care resource utilization in 46% of cases and prevented ambulance transport off-site in 32% of cases (nine cases in total). This corresponded to an absolute risk reduction of 1.3% for the percentage of patients transferred to hospital (PPTH; relative risk reduction of 53%).

Conclusion:

Physicians reported that POCUS improved the diagnosis, management, and disposition of select patients at a remote, multi-day music festival. Also, POCUS reduced ambulance transfers off-site and reduced the perceived burden on broader health care utilization.

PragerR, SedgwickC, LundA, KimD, HoB, StachuraM, GutmanS. Prospective Evaluation of Point-of-Care Ultrasound at a Remote, Multi-Day Music Festival. Prehosp Disaster Med. 2018;33(5):484–489.

Keywords

diagnostic ultrasoundmass-gathering medicineultrasonography
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 5 , October 2018 , pp. 484 - 489
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest: AL leads a university-linked academic program in mass-gathering medicine. AL has worked for over 30 years in volunteer and contracted roles as a clinician and medical director at mass-gathering events and is a co-owner of several companies related to the provision of medical services. SG is president of Rockdoc Consulting Inc. (Vancouver, British Columbia, Canada). Rockdoc is a commercial provider of event medical services. Rockdoc was contracted to provide medical services for the Pemberton Music Festival (Pemberton, British Columbia, Canada). All other authors have no conflicts of interest to declare.

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