Point-of-Care Ultrasound for Pulmonary Concerns in Remote Spaceflight Triage Environments

Abstract

Ultrasound has traditionally been viewed as a less than optimal modality for diagnosis and treatment of the pulmonary system, as air-interfaces disrupt ultrasound views. Researchers have recently identified various lung signs and patterns indicative of lung injuries and illness improving the utility of pulmonary ultrasound. The compact size and ease of use of portable ultrasound machines has helped personnel involved in disaster relief, military operations, and, more recently, in support of operations on the International Space Station. With a goal towards longer duration missions, eventual exploration of Mars, and the development of the commercial space industry participants of varying ages and medical comorbidities will engage in activities with risk for pulmonary injuries such as pneumothorax, ebullism, and decompression sickness. The use of protocols to rapidly perform a pulmonary ultrasound exam could aid in triage and treatment of these participants. A systematic review of published literature on human studies was conducted involving the use of point-of-care pulmonary ultrasound techniques, ultrasound use in austere environments, and suggested examination protocols for triage and diagnosis. Recent studies support the utility and comparability of pulmonary ultrasound examinations to computed tomography and chest radiography, allowing for successful use in a wide variety of austere environments. Pulmonary injury and illness are among the potential health risks facing astronauts during orbital and suborbital space activities. The implementation of point-of-care ultrasound protocols could aid in the rapid diagnosis, triage, and treatment of such injuries should they arise. Ultrasound, with proper training and equipment, can be an invaluable tool to a medical first responder supporting spaceflight operations.