Can handheld micropower impulse radar technology be used to detect pneumothorax? Initial experience in a European trauma centre

• Published in: Injury Vol. 44; no. 5; pp. 650 - 654
• Main Authors: Albers, C.E, Haefeli, P.C, Zimmermann, H, de Moya, M, Exadaktylos, A.K
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Chest tube; Detection; Device performance; Early Diagnosis; Emergency Medicine - instrumentation; Emergency Medicine - methods; Female; Humans; Male; Microcomputers; Micropower impulse radar; Middle Aged; MIR; Monitoring, Physiologic - instrumentation; Monitoring, Physiologic - methods; Orthopedics; Pneumothorax; Pneumothorax - diagnosis; Pneumothorax - etiology; Pneumothorax - mortality; Preclinical; Prospective Studies; Quality control; Radar - instrumentation; Reproducibility of Results; Sensitivity; Sensitivity and Specificity; Specificity; Switzerland - epidemiology; Thoracic Injuries - complications; Thoracic Injuries - diagnosis; Thoracic Injuries - mortality; Thorax drain; Tomography, X-Ray Computed; Trauma Centers; Trauma centre; Switzerland; Pneumothorax; Sensitivity; Specificity; Trauma centre; Thorax drain; Quality control; Chest tube; MIR; Micropower impulse radar; Preclinical; Device performance; Detection
• DOI: 10.1016/j.injury.2012.02.001
• EISSN: 1879-0267
• ISSN: 0020-1383

Abstract Background Pneumothoraces are a common injury pattern in emergency medicine. Rapid and safe identification can reduce morbidity and mortality. A new handheld, battery powered device, the Pneumoscan (CE 561036, PneumoSonics Inc., Cleveland, OH, USA), using micropower impulse radar (MIR) technology, has recently been introduced in Europe for the rapid and reliable detection of PTX. However, this technology has not yet been tested in trauma patients. This is the first quality control evaluation to report on emergency room performance of a new device used in the trauma setting. Material and methods This study was performed at a Level I trauma centre in Switzerland. All patients with thoracic trauma and undergoing chest X-ray and CT-scan were eligible for the study. Readings were performed before the chest X-ray and CT scan. The patients had eight lung fields tested (four on each side). All readings with the Pneumoscan were performed by two junior residents in our department who had previously received an instructional tutorial of 15 min. The qualitative MIR results were blinded, and stored on the device. We then compared the results of the MIR to those of the clinical examination, chest X-ray and CT-scan. Results 50 patients were included, with a mean age of 46 (SD 17) years. Seven patients presented with PTX diagnosed by CT; six of these were detected by Pneumoscan, leading to an overall sensitivity of 85.7 (95% confidence interval 42.1–99.6)%. Only two of seven PTX were found during clinical examination and on chest X-ray (sensitivity 28.6 (95% CI 3.7–71.0)%). Of the remaining 43 of 50 patients without PTX, one false-positive PTX was found by the Pneumoscan, resulting in a specificity of 97.7 (95% CI 87.7–99.9)%. Discussion The Pneumoscan is an easy to use handheld technology with reliable results. In this series, the sensitivity to detect a PTX by the Pneumoscan was higher than by clinical examination and chest X-ray. Further studies with higher case numbers and a prospective study design are needed to confirm our findings.