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RESEARCH

 

CASE REPORT

ABSTRACT

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 literature

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.

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Thanks to this paper point of care ultrasound is now commonplace onboard cruise ship medical centers.

ORIGINAL ARTICLE

ABSTRACT

Background: Serological tests provide an important tool to diagnose previous exposure to the severe acute respira-tory syndrome coronavirus 2 (SARS-CoV-2). Herein we describe the relationship between the demographics, clin-ical characteristics, and molecular investigations and the presence of coronavirus disease 2019 (COVID-19) anti-bodies.

Methods: Three hundred and four participants, living in Gauteng, South Africa, were screened for COVID-19 an-tibodies between September 12, and December 12, 2020. Indications for serological testing included previous in-fection (n = 45, 14.80%), World Health Organization (WHO) symptoms (n = 122, 40.13%), positive household contact (n = 40, 13.16%), and/or positive close non-household contact (n = 80, 26.32%).

Results: There were 58 (19.08%) positive rapid antibody tests. Risk factors associated with a positive rapid anti-body test included WHO symptoms, namely fever/chills (odds ratio [OR] 3.50, 95% confidence interval [CI] 1.50 to 8.19), loss of taste or smell (OR 8.66, 95% CI 3.27 to 22.94), and the presence of a household contact (OR 3.66, 95% CI 1.59 to 8.40).

Conclusions: The findings support the measures implemented to reduce the spread of infection.

(Clin. Lab. 2021;67:xx-xx. DOI: 10.7754/Clin.Lab.2021.210138)

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