Impact of the practice of "Extended Focused Assessment with Sonography for Trauma" (e-FAST) on clinical decision in the emergency department

Uz, İ̇lhan; Yürüktümen, Aslıhan; Boydak, Bahar; Bayraktaroğlu, Selen; Özçete, Enver; Çevrim, Özgür; Ersel, Murat; Kıyan, Selahattin

doi:10.5505/tjtes.2013.23326

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…In our study, it was demonstrated that the POCUS can be used to diagnose LB fractures with short-term training. In other studies similar to our study, it was demonstrated that the POCUS had high accuracy rates with short-term trainings for diagnosing bone fractures [6,7,9]. In addition, in a study comparing POCUS to CT in determining elbow injuries, POCUS had a high accuracy rate after short-term training [1].…”

Section: Discussionsupporting

confidence: 84%

“…Ultrasonography (US) is currently used in ED for the management of trauma patients and in the resuscitation processes, as well as for identifying abdominal, cardiothoracic, and vascular injuries [5,6]. US is advantageous because it is easily accessible, inexpensive, reproducible, portable, free of ionizing radiation, and it provides real-time imaging.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

et al. 2019

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Background and objectives: In this study, the accuracy of point-of-care ultrasonography (POCUS) was compared to radiography (XR) in the diagnosis of fractures, the determination of characteristics of the fractures, and treatment selection of fractures in patients admitted to the emergency department (ED) due to trauma and suspected long bone (LB) fractures. Materials and Methods: The patients were included in the study, who were admitted to ED due to trauma, and had physical examination findings suggesting the presence of fractures in LB (humerus, radius, ulna, femur, tibia, and fibula). The patients were evaluated by two emergency physicians (EP) in ED. The first EP examined LBs with POCUS and the second EP examined them with XR. LBs were evaluated on the anterior, posterior, medial, and lateral surfaces and from the proximal joint to the distal one (shoulder, elbow, wrist, hip, knee, and ankle joint) in both longitudinal and transverse axes with POCUS. Results: A total of 205 patients with suspected LB fractures were included in the study. LB fractures were determined in 99 patients with XR and in 105 patients with POCUS. The sensitivity, specificity, positive predictive value, negative predictive value of POCUS in determining the fractures were 99%, 93%, 93%, and 99%, respectively, compared to XR. Compared to XR, POCUS was able to determine 100% of fissure type fractures (kappa (κ) value: 0.765), 83% of linear fractures (κ: 0.848), 92% of fragmented fractures(κ: 0.756), 67% of spiral fractures (κ:0.798), 75% of avulsion type fractures (κ: 0.855), and 100% of full separation type fractures (κ: 0.855).Conclusions: This study has demonstrated that POCUS has a high sensitivity in diagnosing LB fractures. POCUS has a high sensitivity in identifying fracture characteristics. POCUS can be used as an alternative imaging method to XR in the diagnosis of LB fractures and in the determination of fracture characteristics.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

et al. 2019

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“…Unlike other imaging resources, no access problems were experienced with bed-side ultrasonography devices owing to the adequate numbers of such devices, their use by multiple patients, their use in trauma patients as a part of the examination, and the speed of the procedure. [18] In the 1 st h, CT and laboratory were the most frequently used resources for coding. It was difficult to perform dozens of CT scans at the same time, and accordingly, the scans were performed in the order of urgency based on the appropriate triage.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Management After the 2020 Aegean Sea - Izmir Earthquake

Uz¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This article aims to provide an up-to-date resource on disaster management by reporting about the destructive features of the earthquake that occurred on October 30, 2020, and about the hospital and emergency service organization during a pandemic. METHODS:This study was carried out with a multicentered, cross-sectional retrospective design on the victims of the 2020 Aegean Sea -Izmir earthquake. Local ethics committee approval was obtained. The data obtained by obtaining permission from two hospitals and ambulance services (transport data) located in the region where earthquake-related destruction was most prominent were evaluated. Patient data including demographic data, time of arrival to the emergency department, duration of stay under the debris, triage codes (green: not urgent, slightly injured; yellow: may be delayed, injured; red: critically injured; and black: dead), type of injuries, duration of stay in the emergency department, crush syndrome, rhabdomyolysis, need for invasive procedures (e.g., surgery and dialysis), intensive care admission, hospital admission, and discharge were evaluated. RESULTS:In total, 313 patients (60.4% females) were included in the study according to the inclusion criteria. The mean age of the participants was 38.0±21.0 years, with the youngest being a 6-month-old baby and the oldest a 91-year-old individual. Approximately 41.5% of the earthquake victims presented to the emergency department within the first 3 h of the earthquake, and patients with yellow triage code were the most common in the 1 st h. Further, 35.2% of the patients who were rescued from under the debris were discharged alive. Four patients were discharged alive after being rescued from under the debris 24 h following the earthquake, of whom three were rescued after >48 h (longest duration, 91 h). Further, 32 (15.9%) patients who survived upon presentation to the emergency department had rhabdomyolysis, 4 (1.9%) underwent hemodialysis in the emergency department due to acute renal failure, and 8 (3.8%) underwent other emergency operations such as fasciotomy and amputation. In total, 122 patients died and 191 patients were discharged from the hospitals. Furthermore, 139 patients were discharged from the emergency department, 15 were admitted to the intensive care unit, 41 were hospitalized in the relevant clinics, and 112 were directly transferred to the morgue following preliminary evaluation.CONCLUSION: Emergency services should be ready in terms of accurate registration, correct data entry, correct triage assignment, sufficient resources, adequate team, sufficient equipment, and adequate treatment areas for disasters such as earthquakes. Further, adequate disaster trainings should be provided, feasible disaster relief plans should be prepared, and regular exercises should be conducted.

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“…It is a quick, non-invasive, inexpensive and easily repeatable life saving tool. Non-radiologists, from paramedics to surgeons, can be trained to use it as the technique is problem based rather than organ based requiring much less theoretical knowledge and practical skills from the part of the operator compared to those required for conventional Ultra sound (US) Examination (3). Many inexpensive portable machines have been designed.…”

Section: Introductionmentioning

confidence: 99%

Study on value of Extended-Focused Abdominal Scan For Trauma (e-FAST) performed by non-radiologist emergency care doctors in Management of Trauma at Emergency Trauma Centre, Teaching Hospital, Karapitiya,Galle, Sri Lanka

Seneviratne

Kumara

Kumarasinghe

et al. 2015

Anuradhapura Med. J.

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BackgroundThis study was designed to evaluate the accuracy and usefulness of ultrasound in the hands of emergency physicians and medical officers who are non-radiologistsin assessing Trauma patients at Emergency Trauma Centre(ETC) at Teaching Hospital, Karapitiya, Galle, Sri Lanka Methodology We performed an observational study on Trauma patients admitted to Emergency Department at Teaching Hospital, Karapitiya from 1.12.2014 to 31.12.2014 who fulfilled indications for e-FAST using a specially designed performa. Accuracy of eFAST was tested by comparing the original with subsequent imaging, clinical decision by surgeons, findings at surgery or more than one of the above. Results 69 patients fulfilled the entry criteria.Nineteen of the scans were performed by consultants while rest was done by senior medical officers. All of them were trained in eFAST.Of the 20 scans which were positive there were four pneumothoraxes and one haemothorax. 15 scans which were positive for intraperitoneal free fluid were later. Out of 49 Patients who had negative scans 47 did not require surgery or any interventions. Other two required laparotomy later. Sensitivity and specificity of eFast was 90.4% and 97.9% respectively. Positive predictive value was 95.0% while Negative predictive value was at 95.9% . Conclusions eFAST is a rapid and reliable alternative in detecting free intra-abdominal fluid as well as pneumotorax and haemothorax. It is a safe decision making tool which can be used with confidence and accuracy after brief training and experience by non radiologists which will reduce morbidity and mortality in trauma patients of Sri Lanka.

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Impact of the practice of "Extended Focused Assessment with Sonography for Trauma" (e-FAST) on clinical decision in the emergency department

Cited by 7 publications

References 14 publications

Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

Emergency Department Management After the 2020 Aegean Sea - Izmir Earthquake

Study on value of Extended-Focused Abdominal Scan For Trauma (e-FAST) performed by non-radiologist emergency care doctors in Management of Trauma at Emergency Trauma Centre, Teaching Hospital, Karapitiya,Galle, Sri Lanka

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