[Optimized management of polytraumatized patients by prehospital ultrasound]

Abstract

Aim: The purpose of the study was to evaluate the practicability and the benefit of focused abdominal sonography for trauma (FAST) on scene.

Methods: Prehospital ultrasound was performed on 61 patients being suspicious for abdominal trauma. Free fluid in the Koller's and Morison's pouch, pelvis and pleural space was investigated. After admission routine ultrasound and computer tomography scan was obtained to control prehospital findings.

Results: The mean investigation time was 2.8+/-1.2 min. In 16 patients (26.2%) free fluid was detected with 7 massive and 9 moderate findings. 3 patients died on the scene due to their abdominal injuries. 4 patients underwent laparotomy immediately after admission with 3 splenectomies performed. There was one false positive but no negative FAST resulting in a specificity of 97.5% and sensitivity of 100%. In 37% of the cases the prehospital management was modified and hospital selection was influenced in 21% of the cases due to the findings of the FAST.

Conclusion: In the present study the data have shown that the prehospital ultrasound is a useful and reliable tool for diagnostic procedure on the scene. The data are the basis for a multicenter study in the helicopter rescue service. This study will try to answer the question whether prehospital ultrasound may be generally recommended in trauma patients suspicious for abdominal trauma.