A PROSPECTIVE EVALUATION OF ABDOMINAL ULTRASOUND IN BLUNT TRAUMA - ISIT USEFUL

Objective: The purpose of this study is to evaluate the utility and fe asibility of abdominal ultrasound (US) in blunt trauma patients. Desig n: This prospective study examined the operational issues and the diag nostic accuracy of US in selected blunt trauma patients triaged to a L evel 1 trauma center. Materials and Methods: All patients were evaluat ed by an attending trauma surgeon and our usual criteria for objective evaluation of the abdomen were applied, US was performed by US techni cians and interpreted by the trauma surgeon. We prospectively evaluate d the availability (time to arrival), the ease with which the US could be integrated into the resuscitation (minutes to start after arrival) , and the time required to perform the study, The US results were comp ared to diagnostic peritoneal lavage and computed tomography findings, clinical course, operative findings, and to repeat US examinations to determine sensitivity, specificity, and usefulness. Measurements and Main Results: A total of 800 US studies were performed over 15 months, In four cases (0.5%), the US was incomplete for technical reasons. Th e results in the remaining 796 studies were as follows: [GRAPHICS] The average time to arrival of the US,vas 17.3 minutes (range 0-120) and the average minutes to start after arrival was 7.0 (range 1-49), The a verage time required to perform the study was 10.6 minutes (range 2-26 ). Conclusions: This study demonstrates that US can be obtained rapidl y, integrated into the resuscitation, and completed quickly, US provid es a highly accurate, noninvasive method to evaluate the abdomen in th e blunt trauma patient, and has supplanted the previously used methods at this institution.