1,000 Consecutive Ultrasounds for Blunt Abdominal Trauma

McKenney, Mark; Martin, Ludmila Katherine; Lentz, Kimberley; López, Cristina Pérez; Sleeman, Danny; Aristide, George; Kirton, Orlando C.; Nuñez, Diego; Najjar, R.; Namias, Nicholas; Sosa, Jorge

doi:10.1097/00005373-199604000-00015

Cited by 230 publications

(100 citation statements)

References 19 publications

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“…In blunt trauma studies investigating FAST scanning, outcomes have demonstrated an average specificity of 90 -99% and sensitivity of 86 -99%. [4][5][6][7][8] Sensitivity in this study was therefore comparable. In accordance with previous evidence, our study also demonstrated excellent specificity of FAST (100%) regardless of mechanism of injury.…”

Section: Discussionsupporting

confidence: 55%

FAST scanning in the developing world emergency department

Smith

Postma²,

Wood³

2010

S Afr Med J

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Section: Discussionsupporting

confidence: 55%

FAST scanning in the developing world emergency department

Smith

Postma²,

Wood³

2010

S Afr Med J

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“…[8][9][10] Beyond the ED, ultrasonography for trauma assessment has been adopted by military personnel for field use 22 and as a screening test in mass-casualty situations. 23,24 Although bedside ultrasonography has become a modality taught in both adult surgical and emergency medicine residency programs, 15,16 this has not translated into the pediatric training environment.…”

Section: Discussionmentioning

confidence: 99%

“…EDUS has been shown to be useful in adults as a screening modality for suspected IAI, [8][9][10] with a recent randomized controlled trial showing a 64% reduction in time to operative care compared to CT alone. 11 The applicability of EDUS in children is less well established.…”

mentioning

confidence: 99%

Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

Cardamore

Nemeth

Meyers

2012

CJEM

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Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

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“…In 3 studies, as a decision making tool for the need for laparotomy in hypotensive patients (BP <90 systolic ), FAST had a sensitivity of 100%, specificity of 96% and a negative predictive value of 100% (Wherret et al, Rozycki et al, McKenny et al) In the detection of free intra-abdominal fluid when compared to a reference standard such as DPL/CT or laparotomy, FAST had a sensitivity of 75%, a specificity of 98% and a negative predictive value of 98%(18 studies, 6324 patients, 1992 to 2000) [9][10][11]. The minimum amount of fluid that can be detected is 70 -250mls depending on the study [12].…”

Section: Pregnant Womenmentioning

confidence: 99%