Trauma Ultrasound

Abstract

Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures.

Complex endocrine pathology discovered during investigations performed after politrauma - forensic implications

“…Similarly, abdominal ultrasonography is currently the first option when investigating potential traumatic consequences; in our case no pathological findings were described except for the cystic adrenal appearance, possibly in relation to small posttraumatic haemorrhage [17]. However, the abdominal CT did not confirm the presence of liquid components and was concordant with the final pathological examination.…”

Diagnostic Accuracy of Rapid Ultrasound in Shock (RUSH) Exam; A Systematic Review and Meta-analysis

“…Shock is a life-threatening condition which is typically divided into four categories: cardiogenic, hypovolemic, distributive, obstructive [ 1 ]. There is an increasing trend in the number of cases of shock following the increase in accidents leading to traumatic shocks [ 2 ]. Since each type of shock requires a special treatment, we need quick-detection techniques for all kinds of shock in the emergency room and critical care units [ 2 ].…”

Basic ultrasound training assessment in the initial abdominal trauma screening

“…Aiming to improve the initial screening of trauma patients, more than two decades ago the use of ultrasound (Focused Assessment with Sonography in Trauma -FAST) was incorporated into the initial assessment of trauma victims, under the approval of the American College of Surgeons, through the Advanced Trauma Life Support (ATLS) program 1,[4][5][6] . This evaluation tool resulted in a change in the diagnostic management of multiple trauma patients, replacing the peritoneal lavage method in the assessment of abdominal trauma, particularly in unstable patients 4,7,8 .…”

“…Physical examination in multiple trauma patients may be made difficult by the presence of several lesions, as well as the possibility of low level of consciousness level, shock of unknown etiology, central nervous system lesions and other clinical manifestations that make diagnosis difficult at the clinical examination only 1 . FAST consists of a non-invasive ultrasound examination that can be quickly performed by the patient's bedside, aiming to clarify specific clinical issues, regardless of the trauma mechanism that affected the patient 1,3,4,7,8 . Regarding FAST accuracy in the assessment of abdominal trauma, the sensitivity is 62% to 94% and the specificity is greater 1 -Universidade Estadual do Oeste do Paraná, Serviço de Cirurgia Geral, Cascavel, PR, Brasil.…”