In-flight thoracic ultrasound detection of pneumothorax in combat.
The Journal of emergency medicine · 2009-10-30 · Case report
Abstract
BACKGROUND: Ultrasonography is the only portable imaging modality available in the helicopter medical evacuation environment where physical examination is limited, auscultation is impossible, long transport times may occur, and altitude variations are frequent. Although the use of ultrasonography by aviation medical personnel has been documented, minimal literature exists on the contribution of in-flight ultrasonography to patient management. OBJECTIVES: This case demonstrates an indication for the use of in-flight ultrasonography. It shows how it can affect in-flight management and direct lifesaving intervention. CASE REPORT: A patient with blast injury developed hemodynamic instability of unclear etiology during transport in the combat aviation environment. To our knowledge, this is the first reported case where in-flight thoracic ultrasonography augmented physical examination and diagnosed an untreated pneumothorax when auscultation was impossible. It directed the decision to perform in-flight procedural intervention with tube thoracostomy. This rapidly improved the patient's hemodynamic stability in a remote and hostile setting. CONCLUSION: In-flight thoracic ultrasonography is a portable imaging tool that can be used by aviation medical personnel to detect pneumothorax in environments where physical examination is limited and auscultation is impossible.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Military & tactical · Point-of-care ultrasound · Thoracostomy
Related articles
- En Route Resuscitation - Utilization of CCATT to Transport and Stabilize Critically Injured and Unstable Casualties. (Mil Med, 2019)
- Assessing the evolution of pre-hospital combat casualty care: A comparative study of two conflicts a decade apart. (Am J Emerg Med, 2025)
- A Descriptive Study of Casualties Evacuated Out of Afghanistan by Critical Care Air Transport Teams During the Withdrawal of U.S. Troops. (Mil Med, 2024)
- Aeromedical Evacuation From a Level 2 Field Hospital in UNMISS: Operational Characteristics and In-Flight Medical Interventions, 2023-2025. (Mil Med, 2026)
- Life and Limb In-Flight Surgical Intervention: Fifteen Years of Experience by Joint Medical Augmentation Unit Surgical Resuscitation Teams. (J Spec Oper Med, 2020)
- The importance of systematic point-of-care ultrasound for chest pain with ST-segment elevation: A case report of takotsubo cardiomyopathy precipitated by spontaneous pneumothorax (Hong Kong Journal of Emergency Medicine, 2019)