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Case Reports
. 2017 May 16;20(2):171-177.
doi: 10.1007/s40477-017-0252-7. eCollection 2017 Jun.

Ultrasound as point of care in management of polytrauma and its complication

Saverio Latteri  1   2 , Giulia Malaguarnera  3 , Maurizio Mannino  1 , Antonio Pesce  4 , Giuseppe Currò  5 , Stefania Tamburrini  6 , Mario Scuderi  7
Affiliations
Case Reports

Ultrasound as point of care in management of polytrauma and its complication

Saverio Latteri et al. J Ultrasound. .

Abstract
in English, Italian

Purpose: Traumatic injuries constitute a major risk for patients in emergency units. Point-of-care ultrasound may be a determinant in reducing the deleterious impact of complications and in prognosis.

Methods: We describe the case of a 28-year-old female who reported cranial trauma, abdominal and thoracic trauma, and suspected bilateral fracture of the femur.

Results: Ultrasound was useful for evaluating and monitoring multiple organ failure.

Conclusion: Combining cost-effective advantages with bedside real-time imaging, ultrasound is a powerful adjunct to standard clinical assessment in the management of polytrauma when it is administered at the point of care.

Scopo: le patologie traumatiche rappresentano il maggiore rischio dei pazienti nelle Unità di Emergenza. L’ecografia consentendo una diagnosi precoce sia del tipo di trauma sia delle complicanze che da questo potrebbero derivane, può rappresentare un mezzo importante per la prognosi e per l’eventuale terapia.

Metodi: A tale scopo, noi presentiamo un caso paradigmatico di una paziente di 28 anni che, a seguito di un incidente, aveva riportato dei traumi al cranio, all’addome e al torace e sospetta frattura bilaterale al femore. Al momento del ricovero la paziente era monitorizzata tramite ecografia. I dati venivano confermati sia dalla sintomatologia clinica obiettiva, sia dalla tomografia assiale computerizzata.

Risultato: l’uso dell’ecografia ha consentito una diagnosi precoce non solo del tipo di trauma, ma anche ha permesso un corretto intervento terapeutico ed un monitoraggio anche dell’attività cardiaca.

Conclusione: L’ecografia presenta vantaggi dal punto di vista costo-beneficio ed è utile sia ai fini diagnostici, sia ai fini terapeutici.

Keywords: Cost benefits; Emergency; Trauma; Ultrasound.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Consent for publication

The patient included in this study signed consensus form to publish the data collected. All sensitive data were collected and protected in respect of present privacy statements.

Figures

Fig. 1
Fig. 1
a EFAST B/M mode: right PNX with stratosphere sign. b EFAST B/M mode: after-drainage control with beach sign appearance
Fig. 2
Fig. 2
a POC-US: small and collapsed IVC with hypovolemia. b POC-US: small and hyperkinetic and hypovolemia profile in heart’s chambers. c POC-US: liquid layer in Morison pouch. d POC-US: liquid layer in Douglas pouch
Fig. 3
Fig. 3
a POC-US: normovolemic expanded IVC. b POC-US: normovolemic profile cardiac chambers; normal cardiac kinetics and volume
Fig. 4
Fig. 4
Thorax–abdomen CT scans: hepatic contusion between S5 and S8 with a small abdominal effusion
Fig. 5
Fig. 5
a, b 2 Screenings right femur RX: diaphyseal fracture. c, d Two screenings left femur: diaphyseal fracture. e, f Rx control after damage control orthopedics (DCO)
Fig. 6
Fig. 6
Hepatic CE-US: stable S8 hepatic lesions (4th post-op day)
Fig. 7
Fig. 7
a POC-US dry lung. b Heart POC-US: severe dilatation of the right cardiac chambers, flattening of the IVS, severe hypokinetics of the free wall of the right ventricular, apex hyperkinetics. c POC-US IVC: dilatation and absence of collapsing of the IVC (spontaneously breathing patient). d Right leg CUS: DVT right femoral vein
Fig. 8
Fig. 8
Lungs angio-CT: massive pulmonary artery thrombosis
Flowchart 1
Flowchart 1
Reason to use ultrasound in emergency
Flowchart 2
Flowchart 2
Assessment ultrasound in emergency care
See this image and copyright information in PMC

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