Use of Ultrasonography in the Evaluation of Blunt Abdominal Trauma

Jarowenko, Daleela; Hess, Robert M.; Herr, Mary Sue; Young, William W.; Beyer, Frederick C.

doi:10.1097/00005373-198907000-00045

Cited by 11 publications

(4 citation statements)

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“…Other authors who favoured the use of US for the initial approach to patients with blunt trauma include Jarowenko et al (1989), Bode et al (1993), Luks et al (1993), Rothlin et al (1993), , Glaser et al (1994), Ma et al (1995), Boulanger and McLellan (1996), Healey et al (1996), McKenney et al (1996, Wherrett et al (1996), Smith (1997), andPorter et al (1997). Taking into account all these studies, overall accuracy of US ranges from 96 to 98%, with sensitivity of 73-99% and specificity of 90-100%.…”

Section: Ultrasonography (Us)mentioning

confidence: 99%

Imaging in abdominal trauma

Wherry

Punzalan

2000

Trauma

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Prompt recognition and timely intervention both play a crucial role in managing patients with blunt abdominal trauma. In most cases of multiply injured patients, where physical examination is indeterminate, a rapid and accurate screening method is a valuable adjunct for care-providers. Through the years, different imaging techniques have been utilized for this purpose; among them are diagnostic peritoneal lavage (DPL), ultrasonography (US) and computed tomography (CT). Proponents of each modality have their own beneficial reasons for adopting that particular method of imaging. Needless to say, despite the high sensitivity and specificity values cited for each, all the methods have their own limitations. After having reviewed the advantages and disadvantages of these three modalities, this article suggests that there is not one single modality that is considered the best. Rather, all three can be complementary and the use of each can be appropriate for a particular subset of patients, given a particular clinical situation, and taking into account the resources available.

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Section: Ultrasonography (Us)mentioning

confidence: 99%

Imaging in abdominal trauma

Wherry

Punzalan

2000

Trauma

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“…This research culminated in the description of the Focused Assessment with Sonography for Trauma, or the FAST examination. [1][2][3][4][5][6][7][8] In most trauma centers, the FAST examination has replaced diagnostic peritoneal lavage as the preferred method of initial evaluation and been fully integrated into Advanced Trauma Life Support (ATLS). Consequently, the FAST examination is the initial ultrasound examination for trauma victims performed by trauma surgeons and emergency physicians and is the prototype of emergency ultrasonography.…”

Section: Introductionmentioning

confidence: 99%

An overview of emergency ultrasound in the United States

Michalke¹

2012

World Journal of Emergency Medicine

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BACKGROUND: As emergency ultrasound use explodes around the world, it is important to realize the path its development has taken and learn from trials and tribulations of early practitioners in the fi eld. METHODS: Approaches to education, scanning, documentation, and organization are also described. RESULTS: Machines have reduced in price and once purchased further material costs are low. Staffi ng costs in terms of training, etc have yet to be assessed, but indications from elsewhere are that these are low. Length of stay in the emergency department dramatically decreases, thus increasing patient satisfaction while maintaining an even higher standard of care. CONCLUSION: Emergency screening ultrasound is now a nationally accepted tool for the rapid assessment of the emergency patient.

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“…Like CT, it can identify the likely source, as well as the presence, of free fluid (presumably blood) within the peritoneal cavity and by repeated evaluation can determine whether haemorrhage is continuing. Its utility is now beyond question (Endoh et al, 1987;Chambers et al, 1986;Chambers & Pilbrow, 1988;Gruessner et al, 1989;Tiling et al, 1989;Jarowenko et al, 1989) but grave doubts exist as to whether it can replace DPL and CT. Experienced operators can detect as little as 50 ml of fluid within the abdomen but emphasize, that again, a considerable learning curve exists.…”

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confidence: 99%

“…In most large series a false negative (i.e., missed injury) rate of 1 in 10 is recorded and it is clear that these missed diagnoses have contributed directly to patient death. At times ultrasound has failed to detect exsanguinating intra-abdominal haemorrhage (Jarowenko et al, 1989;Gruessner et al, 1989). Ultrasound thus appears to be safest and most useful when it shows a positive finding in a stable patient.…”

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confidence: 99%