Evidence for cost-effectiveness of ultrasound in evaluation of blunt trauma patients

Lane, Bennett H.

doi:10.4081/ecj.2016.6057

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…Practical implications of FAST in terms of predicting the need for laparotomy, cost-effectiveness, and reducing time to operative intervention have also been studied. A study by Lane BH showed that FAST examination is clearly cost-effective in unstable patients [12]. Moylan et al noted that even in normotensive patients with blunt trauma, the positive FAST examination had a strong association with therapeutic laparotomy, or 116 [8].…”

Section: Discussionmentioning

confidence: 99%

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POCUS in Abdominal Trauma: Old Gadget, New Insights

Ramaswami¹,

Sinha²

2023

Abdominal Trauma - New Solutions to Old Problems

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Abdominal trauma is difficult to identify, especially in a patient with multiple injuries. Mechanism of injury can guide us to the likely organs injured, but the extent and location cannot be accurately pinpointed in most cases. Owing to the multitude of structures located in the abdomen, timely identification and appropriate intervention are crucial to ensure the good patient outcomes. Focused assessment with sonography in trauma (FAST) and its extended version (eFAST) has become the standard care as per ATLS guidelines in patient evaluation. The main goal is to identify hemoperitoneum, hemothorax, and/or pneumothorax. However, sonography can be applied to detect varying injuries to abdominal viscera, beyond the elementary eFAST examination. This includes assessment of solid organs, hollow viscus, vascular structures, and even soft tissues. Sonography, when wielded with necessary knowledge and practice, can be an incredible asset at the bedside. This chapter aims to explore these possible applications of point of care ultrasonography (POCUS) in abdominal trauma.

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Section: Discussionmentioning

confidence: 99%

“…FAST has even been utilized to grade the amount of intraperitoneal hemorrhage and help decide the need for laparotomy [8,9]. Apt use of FAST has been shown to reduce time to intervention, the need for computed tomography (CT) scans, and reduce hospital stay as well as costs [10][11][12].…”

Section: Focused Assessment With Sonography In Trauma (Fast)mentioning

confidence: 99%

POCUS in Abdominal Trauma: Old Gadget, New Insights

Ramaswami¹,

Sinha²

2023

Abdominal Trauma - New Solutions to Old Problems

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“…Evidence suggests that the use of ultrasound for bedside clinical evaluation is cost-effective [ 10 – 12 , 18 ]. Common applications specific to the emergency setting such as the FAST not only decrease reliance on imaging such as the computed tomography (CT) for evaluation in stable patients, but also promote an efficient cost-effective approach to patient care [ 9 ]. Similarly, we found significantly lower total mean charges from pre- to post-intervention, $3,762 vs. $2,622, p = 0.009.…”

Section: Discussionmentioning

confidence: 99%

Effect of a point-of-care ultrasound (POCUS) curriculum on emergency department soft tissue management

et al. 2022

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Background Pediatric emergency department (ED) visits for superficial skin and soft tissue infections (SSTI) have steadily been increasing and point-of-care ultrasound (POCUS) continues to be an effective modality to improve management and shorter ED length of stays (LOS). Objective We sought to determine the impact of a soft tissue POCUS curriculum on POCUS utilization, ED LOS, and cost-effectiveness. Methods This was a retrospective pre- and post-interventional study of pediatric patients aged 0 to 17 years. Patients presenting to ED with international classification of disease 9 or 10 code for abscess or cellulitis were included. Data were collected a year before and after curriculum implementation with a 1-year washout training period. Training included continuing medical education, greater than 25 quality assured examinations, and a post-test. We compared diagnostic imaging type, ED LOS, and mean charges in patients with SSTI. Results We analyzed data on 119 total patients, 38 pre- and 81 post-intervention. We found a significant increase in the total number of POCUS examinations performed pre- to post-curriculum intervention, 26 vs. 59 (p = 0.0017). Mean total charges were significantly decreased from $3,762 (± 270) to $2,622 (± 158; p = 0.0009). There was a significant trend towards a decrease in average ED LOS 282 (standard error of mean [SEM] ± 19) vs 185 (± 13) minutes (p = 0.0001). Conclusions Implementation of a soft tissue POCUS curriculum in a pediatric ED was associated with increased POCUS use, decreased LOS, and lower cost. These findings highlight the importance of POCUS education and implementation in the management of pediatric SSTI.

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“…Thus, FAST showed to be a method with a rapid learning curve and easy to use as a propaedeutic tool in the initial assessment of abdominal trauma. FAST is a rapid, low-cost examination that can result in valuable prognostic information in patients who are hemodynamically stable or not 14,15 . Therefore, in hemodynamically stable patients, the method is potentially useful both for the initial screening and to rationalize the use of health resources, reducing the number of requested abdominal CTs and potentially avoiding a hospital transfer for specialized assessment 14,15 .…”

Section: Original Article Abstract Objective: To Verify the Efmentioning

confidence: 99%