Diagnostic value of a hand-carried ultrasound device for free intra-abdominal fluid and organ lacerations in major trauma patients. Issue 3 (19th April 2012)

• Record Type: Journal Article
• Authors: Schleder, Stephan; Dendl, Lena-Marie; Ernstberger, Antonio; Nerlich, Michael; Hoffstetter, Patrick; Jung, Ernst-Michael; Heiss, Peter; Stroszczynski, Christian; Schreyer, Andreas G
• Is Part Of: Emergency medicine journal. Volume 30:Issue 3(2013)
• Page Start: e20
• Page End: e20
• Publication Date: 2012-04-19
• Subjects: Diagnosis -- major trauma -- ultrasound -- hand-carried ultrasound -- free intra-abdominal fluid -- organ laceration -- pre-hospital care -- abdomen; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emermed-2012-201258
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Background: Technological progress has led to the introduction of hand-carried ultrasound (HCU) imagers in clinical workflow. The aim of this study is to analyse whether examination with a HCU device is a rapid and reliable alternative to contrast-enhanced multidetector CT (MDCT) scans in diagnosis of free intra-abdominal fluid and organ lacerations in major trauma patients. Methods: 31 major trauma patients with an injury severity score >15 and the necessity of a MDCT scan (standard of reference) were enrolled prospectively to this study, and additionally examined with a HCU, according to 'focused assessment with sonography for trauma' principles for the assessment of organ lacerations and free intra-abdominal fluid. The HCU device employed was of the latest generation. Statistical analysis was performed using PASW V.18. Results: Four patients were diagnosed with free intra-abdominal fluid (prevalence 12.9%). HCU showed a sensitivity and specificity of 75% and 100%, respectively. Positive predictive value and negative predictive value were 100% and 96%, respectively. Five patients had organ lacerations (prevalence 16.1%). In these cases, the HCU was able to detect organ lacerations with a sensitivity and specificity of 80% and 100%, respectively. Therefore, a positive predictive value and negative predictive value of 100% and 96%, respectively, were calculated. Conclusion: In major trauma patients, examination with HCU according to the 'focused assessment with sonography for trauma' principles for the diagnosis of organ lacerations and free intra-abdominal fluid is a reliable and rapid alternative to MDCT scans and can help save precious time in emergency situations, and should, additionally, be evaluated in the pre-clinical workflow.