|First author, year||n||Study type||Aim||US types, providers||Main results||Rating|
|Quick, 2016||149 patients||Controlled (prehospital paramedics vs in-hospital physicians)||To evaluate the ability of ability of in-flight thoracic US to identify pneumothorax (trauma and medical patients)||Lung (PTX), paramedics compared to ED physicians||
Gold standard chest CT (n = 116). Prehospital sensitivity of 68% (95% CI 46–85), specificity 96% (95% CI 90–98), accuracy 91% (95% CI 85–95). Physician-based ED US; sensitivity 84% (95% CI 62–94),|
specificity 98% (95% CI 93–99), accuracy 96% (95% CI 90–98).
|O’Dochertaigh, 2017||455 missions||Cohort||To describe the use of US to support interventions when used by physicians and non-physicians (trauma and medical patients)||Trauma ultrasound and IVC, highly trained physicians and non-physicians (paramedics)||Interventions was supported in US in 26% (95% CI 18–34) of cases when used by non-physicians, and in 45% (95% CI 34–56) when used by physicians (p < 0.006)||0|
|Roline, 2013||71 (41 scans)||Cohort||To evaluate the feasibility of bedside thoracic US (trauma and medical patients)||Lung (PTX), prehospital care providers (paramedics?)||In 71 eligible patients, 41 (58%) scans were completed. Level of agreement between flight crew and expert substantial with a kappa of 0.67, (95% CI 0.44–0.90). 54% of images were rated “good”. Causes for not completing US were lack of time or space limitation in aircraft.||+|
|Ketelaars, 2013||281 patients, 326 exams||Cohort||To evaluate the impact of US chest examinations on the care of patients in a HEMS service (trauma and cardiac arrest patients)||Heart, lung (PTX), abdomen, experienced physicians||
PTX sensitivity 38%, specificity 97%, PPV 90%, NPV 69%.|
Treatment plan changed in 60 (21%) patients; in 10 (4%) a chest tube was abandoned; in 10 (4%) the destination for definitive care was changed, in 9 (3%) cardiopulmonary resuscitation was stopped and in 31 (11%) there were other changes.
|Chenaita, 2012||130 patients||Diagnostic accuracy||To estimate the diagnostic accuracy of US confirmation of gastric tube placement||Abdominal (gastric), experienced physicians||Sensitivity 98.3% (95% CI 94–99.5), specificity 100% (95% CI 75.7–100). PPV 100%, NPV 85.7%. Correlation between gastric tube size and visualization (larger tubes easier to see)||+|
|Brun, 2014||32||Controlled study (2-point US vs syringe test)||To estimate the diagnostic accuracy of 2-point US to confirm gastric tube placement||Esophageal, abdominal, physicians||100% visualization of gastric tube in the esophagus, 62.5% in the stomach. X-ray confirmed 28/32 in correct position. US higher diagnostic accuracy than syringe test.||0|
|Zadel, 2015||124 patients||Diagnostic accuracy||To assess the sensitivity and specificity of US for confirming endotracheal intubation||Lung (lung sliding and diaphragm excursion), certified physicians||
Gold standard, capnography. US sensitivity 100%, specificity 100%, PPV 100%, NPV 100%.|
Median US time 30 s.