Ultrasound in the austere environment: a review of the history, indications, and specifications

In the last 10 years, the use of ultrasound has expanded because of its portability, safety, real-time image display, and rapid data collection. Simultaneously, more people are going into the backcountry for enjoyment and employment. Increased deployment for the military and demand for remote medicine services have led to innovative use and study of ultrasound in extreme and austere environments. Ultrasound is effective to rapidly assess patients during triage and evacuation decision making. It is clinically useful for assessment of pneumothorax, pericardial effusion, blunt abdominal trauma, musculoskeletal trauma, high-altitude pulmonary edema, ocular injury, and obstetrics, whereas acute mountain sickness and stroke are perhaps still best evaluated on clinical grounds. Ultrasound performs well in the diverse environments of space, swamp, jungle, mountain, and desert. Although some training is necessary to capture and interpret images, real-time evaluation with video streaming is expected to get easier and cheaper as global communications improve. Although ultrasound is not useful in every situation, it can be a worthwhile tool in the austere or deployed environment.