• Josie Acuña, Elaine Situ-LaCasse, Adrienne A Yarnish, Neil L McNinch, and Srikar Adhikari.
• Department of Emergency Medicine, The University of Arizona, College of Medicine, Tucson, Arizona.
• J Emerg Med. 2024 Apr 1; 66 (4): e483e491e483-e491.

BackgroundAs emergency physicians are looking at handheld devices as alternatives to the traditional, cart-based systems, concerns center around whether they are forsaking image quality for a lower price point and whether the handheld can be trusted for medical decision making.ObjectiveWe aimed to determine the feasibility of using a handheld ultrasound device in place of a cart-based system during the evaluation of trauma patients using the Focused Assessment with Sonography for Trauma (FAST) examination.MethodsThis was a prospective study of adult trauma patients who received a FAST examination as part of their evaluation. A FAST examination was performed using a cart-based machine and a handheld device. The results of the examinations were compared with computed tomography imaging. Images obtained from both ultrasound devices were reviewed by an expert for image quality.ResultsA total of 62 patients were enrolled in the study. The mean (SD) time to perform a FAST examination using the handheld device was 307.3 (65.3) s, which was significantly less (p = 0.002) than the 336.1 (86.8) s with the cart-based machine. There was strong agreement between the examination results of the handheld and cart-based devices and between the handheld and computed tomography. Image quality scores obtained with the handheld device were lower than those from the cart-based system. Most operators and reviewers agreed that the images obtained from the handheld were adequate for medical decision making.ConclusionsData support that it is feasible to use the handheld ultrasound device for evaluation of the trauma patient in place of the cart-based system.Copyright © 2023 Elsevier Inc. All rights reserved.

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