Pneumothorax detection in emergency situations must be rapid and at the point of care. Current standards for detection of a pneumothorax are supine chest X-rays, ultrasound, and CT scans. Unfortunately these tools and the personnel necessary for their facile utilization may not be readily available in acute circumstances, particularly those which occur in the pre-hospital setting. The decision to treat therefore, is often made without adequate information. In this report, we describe a novel hand-held device that utilizes Micropower Impulse Radar to reliably detect the presence of a pneumothorax. The technology employs ultra wide band pulses over a frequency range of 500？MHz to 6？GHz and a proprietary algorithm analyzes return echoes to determine if a pneumothorax is present with no user interpretation required. The device has been evaluated in both trauma and surgical environments with sensitivity of 93% and specificity of 85%. It is has the CE Mark and is available for sale in Europe. Post market studies are planned starting in May of 2011. Clinical studies to support the FDA submission will be completed in the first quarter of 2012. 1. Introduction The ability to rapidly identify a pneumothorax (PTX) at the point of care for trauma victims can be life saving. This is particularly true in the military setting where undetected tension PTX is thought to contribute to death in up to 4% of fatal combat cases [1]. Accurate diagnosis of PTX in the prehospital setting depends on physical examination skills which include the ability to look for respiratory distress, jugular venous distension, or tracheal deviation, listen for diminished lung sounds, and feel for crepitus or broken ribs. Detection of such findings however can be challenging [2–4] even when physician providers are involved in patient assessment [5]. Consequently, prehospital protocols often incorporate a low-threshold for intervention when a PTX is suspected clinically [6–10]. Needle decompression, the procedure most commonly performed prehospital for emergent treatment of PTX, is not benign and has the potential to induce substantial morbidity when applied inappropriately [6, 7]. The existence of a quick, practical, easy to use method of diagnosing PTX would greatly improve the margin of error for prehospital providers and facilitate the use of precise, directed intervention for individuals with thoracoabdominal injury. Portable lung ultrasound (US) has high sensitivity and specificity for detection of PTX [11–14] and has been proposed as modality capable of fulfilling this need [15–18].
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