ULTRASOUND BASED KEY CLINICAL PATHWAY REDUCES THE USE OF HOSPITAL RESOURCES FOR THE EVALUATION OF BLUNT ABDOMINAL-TRAUMA

Background: Evaluating blunt abdominal trauma remains a resource inten sive aspect of trauma care, Recently, emergency department ultrasound has been promulgated as a noninvasive diagnostic alternative. Conseque ntly, we hypothesized that an ultrasound based key clinical pathway (K CP) would reduce the number of diagnostic peritoneal lavage (DPL) and computed tomographic (CT) scans required to evaluate blunt abdominal t rauma without increased risk to the patient. Methods: This study was a prospective analysis of patients evaluated for blunt abdominal trauma during a 3-month period using this KCP compared with a 3-month histor ical cohort. Results: Data were collected for 486 KCP patients and wer e compared with 516 patients in the study cohort, No differences were noted regarding demographics, number of laparotomies, or type of injur ies. Using the KCP, DPL was reduced from 17 to 4%, and computed tomogr aphy from 56 to 26%. Furthermore, the injury severity score increased from 11.6 to 21.5 for DPL patients and from 4.6 to 8.3 for computed to mography patients. Ultrasound exams were used exclusively in 65% of pa tients. Conclusions: An ultrasound based KCP resulted in significant r eductions in the use of invasive DPL and costly CT scanning in the eva luation of blunt abdominal trauma without risk to the patient.