A cruise ship emergency medical evacuation triggered by handheld ultrasound findings and directed by tele-ultrasound

Cruise ships travel far from shoreside medical care and present a unique austere medical environment. For the cruise ship physician, decisions regarding emergency medical evacuation can be challenging. In the event that a passenger or crew member becomes seriously ill or is injured, the use of point...

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Bibliographic Details
Published in:	International maritime health Vol. 71; no. 1; pp. 42 - 45
Main Authors:	Boniface, Keith S, Sikka, Neal, Page, Nicholas, Peretz, Asi, Shokoohi, Hamid
Format:	Journal Article
Language:	English
Published:	Poland Wydawnictwo Via Medica 01-01-2020
Subjects:	Abdomen Adult Aircraft Emergency medical care Female Health facilities Humans Medicine Naval Medicine - methods Nurses Ovaries Pain Patients Physicians Point of care testing Ports Pregnancy Pregnancy complications Pregnancy, Ectopic - diagnostic imaging Ships Telemedicine Telemedicine - methods Ultrasonic imaging Ultrasonography - instrumentation Ultrasonography - methods Uterus Vagina Womens health ectopic pregnancy tele-ultrasound cruise ship medical evacuation point-of-care ultrasound
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Summary:	Cruise ships travel far from shoreside medical care and present a unique austere medical environment. For the cruise ship physician, decisions regarding emergency medical evacuation can be challenging. In the event that a passenger or crew member becomes seriously ill or is injured, the use of point-of-care ultrasound may assist in clarifying the diagnosis and stratifying the risk of a delayed care, and at times expedite an emergent medical evacuation. In this report we present the first case reported in the literaturę of an emergency medical evacuation from a cruise ship triggered by handheld ultrasound. A point-of-care ultrasound performed by a trained cruise ship physician, reviewed by a remote telemedical consultant with experience in point-of-care ultrasound, identified an ectopic pregnancy with intraabdominal free fluid in a young female patient with abdominal pain and expedited emergent helicopter evacuation from a cruise ship to a shoreside facility, where she immediately underwent successful surgery. The case highlights a medical evacuation that was accurately triggered by utilising a handheld ultrasound and successfully directed via a tele-ultrasound consultation. American College of Emergency Physicians (ACEP) health care guidelines for cruise ship medical facilities should be updated to include guidelines for point-of-care ultrasound, including training and telemedical support.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1641-9251 2081-3252
DOI:	10.5603/IMH.2020.0010