A prospective evaluation of abdominal ultrasound in blunt trauma: is it useful?

Abstract

Objective: The purpose of this study is to evaluate the utility and feasibility of abdominal ultrasound (US) in blunt trauma patients.

Design: This prospective study examined the operational issues and the diagnostic accuracy of US in selected blunt trauma patients triaged to a Level 1 trauma center.

Materials and methods: All patients were evaluated by an attending trauma surgeon and our usual criteria for objective evaluation of the abdomen were applied. US was performed by US technicians and interpreted by the trauma surgeon. We prospectively evaluated 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 compared 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. The results in the remaining 796 studies were as follows: [table: see text] The average time to arrival of the US was 17.3 minutes (range 0-120) and the average minutes to start after arrival was 7.0 (range 1-49). The average time required to perform the study was 10.6 minutes (range 2-26).

Conclusions: This study demonstrates that US can be obtained rapidly, integrated into the resuscitation, and completed quickly. US provides a highly accurate, noninvasive method to evaluate the abdomen in the blunt trauma patient, and has supplanted the previously used methods at this institution.