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Emerg Med J. 2013 Mar;30(3):e20. doi: 10.1136/emermed-2012-201258. Epub 2012 Apr 19.

Diagnostic value of a hand-carried ultrasound device for free intra-abdominal fluid and organ lacerations in major trauma patients.

Author information

1
Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany. stephan.schleder@ukr.de

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.

PMID:
22518057
DOI:
10.1136/emermed-2012-201258
[Indexed for MEDLINE]

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