Emergency department echocardiography improves outcome in penetrating cardiac injury

Plummer, David; Brunette, Douglas D.; Asinger, Richard W.; Ruiz, Ernest

doi:10.1016/s0196-0644(05)82784-2

Cited by 275 publications

(125 citation statements)

References 12 publications

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“…1,2 Emergency PoCUS has been shown to help differentiate causes of pleuritic chest pain in patients with a normal chest x-ray, 3 to improve diagnostic accuracy and narrow the differential diagnosis in patients with undifferentiated hypotension, 4 to improve time-to-diagnosis and mortality of cardiac trauma patients, 5 and to offer benefit in the accurate and timely diagnosis of acute cardiorespiratory emergencies, 6,7 in addition to other documented benefits. 8 Numerous studies have shown that competence in such PoCUS protocols, including the Focused Assessment with Sonography for Trauma 9 and Prehospital Assessment with Ultrasound for Emergencies 10 can be achieved after short intensive training.…”

Section: Résumémentioning

confidence: 99%

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Parks

Verheul

LeBlanc-Duchin

et al. 2015

CJEM

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Background: Goal-directed point-of-care ultrasound (PoCUS) protocols have been shown to improve the diagnostic accuracy of the initial clinical assessment of the critically ill patient. The diagnostic impact of the Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol was assessed in simulated emergency medical scenarios. Methods: Following a focused PoCUS training program, the diagnostic accuracy, confidence, and precision of 12 medical learners participating in standardized scenarios were tested using high-fidelity clinical and ultrasound simulators. Participants were assessed during 72 simulated cardiorespiratory scenarios. Differential diagnoses were collected from participants before and after PoCUS in each scenario, and confidence surveys were completed. Data were analysed using R software. Results: Prior to PoCUS, 45 (62.5%) correct primary diagnoses were made compared with 64 (88.9%) following PoCUS (χ 2 = 14, 1df, p = 0.0002).PoCUS was also shown to increase

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Section: Résumémentioning

confidence: 99%

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Parks

Verheul

LeBlanc-Duchin

et al. 2015

CJEM

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“…Work originally done by Plummer [16] in 1992 demonstrated the value of bedside ultrasound in the evaluation of penetrating cardiac injuries. In this study, focused bedside echocardiography was performed on 49 patients with penetrating cardiac injuries who were compared with a control group of patients who did not undergo ultrasonography.…”

Section: Techniquementioning

confidence: 99%

Ultrasound in abdominal trauma

Rose

2004

Emergency Medicine Clinics of North America

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Ultrasound in the evaluation of abdominal trauma has evolved over the past 30 years. The use of ultrasound for abdominal trauma was described initially by Kristensen and colleagues [1] in 1971. In 1976, Ascher and colleagues [2] first reported the accuracy of ultrasound in Radiology, with 80% sensitivity for the detection of splenic injury. In a study of 808 patients, Tiling and colleagues [3] in 1990 reported a sensitivity of 89%, a specificity of 100%, and an accuracy of 98%. This same group also was first to comment on the effect of training and experience and reported that surgeons with extensive ultrasound experience could diagnose intra-abdominal fluid with a sensitivity of 96% and an accuracy of 99%. Interest and experience with ultrasound for trauma grew steadily around the world among surgeons and emergency physicians during the early 1990s [4][5][6][7]. During this period, ultrasound technology was improving with regard to price, portability, and resolution, allowing its use during resuscitation. At the same time, in the United States, there was continuing reliance on diagnostic peritoneal lavage (DPL) and CT and much less interest in sonography for abdominal trauma. This all changed when emergency physicians and surgeons in the United States began to publish their experience with ultrasound [4,8,9]. The term Focused Assessment with Sonography for Trauma (FAST) was coined by Rozycki et al [10] in 1996 and has persisted as the accepted acronym for the trauma ultrasound evaluation. The basic four-view examination (perihepatic, perisplenic, pelvic, and pericardial views) has become the foundation of the FAST examination. The rapid, noninvasive, and practical nature of ultrasound for bedside evaluation of critically injured patients has changed the evaluation of blunt abdominal trauma.

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“…5, при стабильной ге-модинамике имеется достаточно времени для пол-ноценного дооперационного обследования. В слу-чае если рутинное ультразвуковое исследование не свидетельствует о наличии гемоперикарда и необхо-димости торакотомии, то целесообразно выполнить комплекс дополнительных обследований [8,21,23,25], поскольку выявить до операции гемоперикард малого объема традиционными методами удавалось редко. Если при эхокардиографии или компьютер-ной томографии в полости перикарда выявляют ми-нимальное количество жидкости, то для исключе- ния гемоперикарда целесообразно выполнение ВТС и перикардиотомии [5].…”

Section: Discussionunclassified

Possibilities of videothoracoscopy for penetrating thoracic injuries

Ov¹,

IuA²,

Mm³

2015

Khir. Z. im. N.I. Pirogova

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ВведениеВидеоторакоскопия (ВТС) получает все боль-шее распространение в лечении повреждений груди. Применение этого метода способствует уменьше-нию хирургической травмы, снижению частоты ра-невых осложнений, сокращению длительности ле-чения и скорейшей реабилитации пострадавших [10,13,17,18]. Использование ВТС возможно у по-страдавших со стабильными показателями гемоди-намики и при объективной оценке тяжести вну-тренних повреждений [11,12,16]. Знание особенно-стей ранений органов и анатомических структур груди способствует обоснованному выбору вида оперативных вмешательств, при этом ВТС может стать одним из основных методов.Цель работы -на основании ретроспективной оценки тяжести повреждений и применения как традиционных, так и эндохирургических методов определить возможность использования ВТС при ранениях груди. Ключевые слова: ранение груди, шоковый индекс, видеоторакоскопия.It was analyzed the medical reports of 596 victims with thoracic injuries including 360 cases with following conventional therapeutic approach and 236 patients who underwent videothoracoscopy. We estimated condition severity in case of injuries of thoracic wall, lungs, pericardium and heart. Hemodynamic disorders were estimated according to Allgower-Burri shock index. Intrapleural bleeding was calculated using volume of hemothorax and time before injury and operation. Severity of physiological damages was determined using RTS criterion, anatomic -using ISS criterion. We estimated possibility for videothoracoscopy in patients with conventional therapeutic approach comparing severity of injuries, severity of condition in both groups and volume of surgery. Retrospective analysis revealed possibility of videothoracoscopy in 86.7% of victims with pulmonary injury, in 83.3% with bleeding at the muscular vessels of thoracic wall, in 40.3% with intercostal vessels injury, in 31.2% with heart injury, in 27.3% with damage of pericardium and in 18.8% with internal thoracic vessels injury. Our investigation revealed that videothoracoscopy may be used more widely in case of thoracic injury.

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Emergency department echocardiography improves outcome in penetrating cardiac injury

Cited by 275 publications

References 12 publications

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Effect of a point-of-care ultrasound protocol on the diagnostic performance of medical learners during simulated cardiorespiratory scenarios

Ultrasound in abdominal trauma

Possibilities of videothoracoscopy for penetrating thoracic injuries

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