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Prospective evaluation of non-radiologist performed emergency abdominal ultrasound for haemoperitoneum

机译:非放射科医生对腹部进行紧急腹部超声的前瞻性评估

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摘要

>Objectives: To evaluate non-radiologist performed emergency ultrasound for the detection of haemoperitoneum after abdominal trauma in a British accident and emergency department. >Methods: Focused assessment with sonography for trauma (FAST) was performed during the primary survey on adult patients triaged to the resuscitation room with suspected abdominal injury over a 12 month period. All investigations were performed by one of three non-radiologists trained in FAST. The ultrasound findings were compared against the investigation of choice of the attending surgeon/accident and emergency physician. The patients were followed up for clinically significant events until hospital discharge or death. >Results: One hundred patients who had sustained blunt abdominal trauma, were evaluated by FAST. Nine true positive scans were detected and confirmed by computed tomography, diagnostic peritoneal lavage, or laparotomy. There was one false positive in this group, giving a sensitivity of 100%, specificity 99%, and positive predictive value of 90%. Ten patients with penetrating injuries were evaluated with a sensitivity and specificity for FAST of 33% and 86% respectively. >Conclusions: Emergency torso ultrasound for the detection of haemoperitoneum can be successfully performed by trained non-radiologists within a British accident and emergency system. It is an accurate and rapid investigation for blunt trauma, but the results should be interpreted with caution in penetrating injury.
机译:>目标:要评估英国放射和急诊科在腹部外伤后非放射科医师进行的紧急超声检查以检测出血性子宫内膜。 >方法:在初次调查中,对在12个月内因腹部受伤而被分诊到复苏室的成年患者进行了超声创伤重点检查(FAST)。所有调查均由接受过FAST培训的三名非放射科医生中的一名进行。将超声检查结果与主治医生/意外和急诊医师的选择调查进行比较。对患者进行临床重大事件的随访,直至出院或死亡。 >结果:通过FAST评估了100例持续腹部钝器伤的患者。通过计算机断层扫描,诊断性腹膜灌洗或剖腹术检测并确认了九次真正的阳性扫描。该组中有一个假阳性,灵敏度为100%,特异性为99%,阳性预测值为90%。对10例穿透性损伤患者进行了评估,其FAST的敏感性和特异性分别为33%和86%。 >结论:在英国事故和紧急情况系统内,受过训练的非放射线医师可以成功地执行紧急躯干超声检查,以检测出血情况。这是对钝器创伤的准确而快速的调查,但在穿透性损伤中应谨慎解释结果。

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