Impact of portable ultrasound in trauma care after the Haitian earthquake of 2010

Shah, Sachita; Dalal, Akshay; Smith, R. M.; Joseph, Giliane; Rogers, Selwyn O.; Dyer, George S.M.

doi:10.1016/j.ajem.2010.06.017

Cited by 64 publications

(15 citation statements)

References 6 publications

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“…While there are reports on the use of RA for pain control in disaster settings, there have been no controlled studies evaluating whether RA has added benefit over narcotics alone [13, 29]. This trial will rigorously evaluate the role of RA and also be the first to assess if a focused training for generalist health care providers is sufficient to effectively perform RA in the aftermath of a major disaster.…”

Section: Discussionmentioning

confidence: 99%

“…However, the injury patterns and clinical parameters of this population are not representative of a post-earthquake setting, where resources are often scarce and injuries more complex. Although there are anecdotal reports on the use of RA from contemporary earthquake events [13, 28, 29], this data is limited and equipoise exists as to whether RA improves pain control for lower extremity injuries of disaster victims. The RAPID study will utilize a blinded RCT equivalence design to address this patient-centered question.…”

Section: Discussionmentioning

confidence: 99%

“…However, there have been no randomized controlled trials (RCTs) conducted to evaluate the effectiveness, safety, or acceptability of RA in the aftermath of a major earthquake [13, 28, 29]. Given the burden of disease, consistent patterns of injuries, and inadequate pain treatment documented in earthquake settings, interventions to address this substantial global health burden are needed.…”

Section: Introductionmentioning

confidence: 99%

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Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial

Levine

Teicher²,

Aluisio

et al. 2016

Trials

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BackgroundLower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting.Methods/designThe Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting. The proposed study is a blinded, randomized controlled equivalence trial among earthquake victims with serious lower extremity injuries in a resource-limited setting. After obtaining informed consent, study participants will be randomized in a 1:1:1 allocation to either: standard care (parenteral morphine at 0.1 mg/kg); standard care plus a landmark-guided fascia iliaca compartment block (FICB); or standard care plus an US-guided femoral nerve block. General practice humanitarian response providers who have undergone a focused training in RA will perform nerve blocks with 20 ml 0.5 % levobupivacaine. US sham activities will be used in the standard care and FICB arms and a normal saline injection will be given to the control group to blind both participants and nonresearch team providers. The primary outcome measure will be the summed pain intensity difference calculated using a standard 11-point Numerical Rating Scale reported by patients over 24 h of follow-up. Secondary outcome measures will include overall analgesic requirements, adverse events, and participant satisfaction.DiscussionGiven the high burden of lower extremity injuries in the aftermath of earthquakes and the currently limited treatment options, research into adjuvant interventions for pain management of these injuries is necessary. While anecdotal reports on the use of RA for patients injured during earthquakes exist, no controlled studies have been undertaken. If demonstrated to be effective in a disaster setting, RA has the potential to significantly assist in reducing both acute suffering and long-term complications for survivors of earthquake trauma.Trial registrationClinicalTrials.gov (NCT02698228), registered on 16 February 2016.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial

Levine

Teicher²,

Aluisio

et al. 2016

Trials

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“…[1][2][3][4][5][6][7][8] POC ultrasonography plays an increasingly important role in emergency medicine training and patient care. 9 Additionally, POC ultrasonography has been incorporated into routine trauma management and is considered standard of care.…”

Section: Introductionmentioning

confidence: 99%

Point-of-Care Ultrasonography in a Domestic Mass Casualty Incident: The Boston Marathon Experience

Eyre

Stone²,

Kimberly³

2016

Emerg Med Open J

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“…Dr. Sachita Shah, an emergency physician of Rhode Island Hospital and one of the key players in the rescue effort, states the use of portable ultrasound in "mass casualty settings" as well as rapid triaging of patients for subsequent surgical or medical management. 2 Their team used the Sonosite Micromaxx TM device to rapidly diagnose intraperitoneal and intrathoracic haemorrhage as well as various other uses from pregnancy assessment to ultrasound guided regional anaesthesia.…”

mentioning

confidence: 99%

The (Ultra)sound of Things to Come

Cabalag¹

2012

JournalMTM

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Impact of portable ultrasound in trauma care after the Haitian earthquake of 2010

Cited by 64 publications

References 6 publications

Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial

Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial

Point-of-Care Ultrasonography in a Domestic Mass Casualty Incident: The Boston Marathon Experience

The (Ultra)sound of Things to Come

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