Rapid detection of traumatic effusion using surgeon-performed ultrasonography.
BACKGROUND
In the injured patient, rapid assessment of the thorax can yield critical information for patient management and triage.


OBJECTIVE
The objectives of this prospective study were (1) to determine if experienced surgeon sonographers could successfully use a focused thoracic ultrasonographic examination to detect traumatic effusion, and (2) to compare the accuracy and efficiency of ultrasonography with supine portable chest radiography.


METHODS
Surgeon-sonographers performed thoracic ultrasonographic examinations on patients with blunt and penetrating torso injuries during the Advanced Trauma Life Support secondary survey. All patients also underwent portable chest radiography. Performance times for ultrasonography and chest radiography were recorded. Comparisons were made of the performance times and accuracy of both tests in detecting traumatic effusion.


RESULTS
In 360 patients, there were 40 effusions, 39 of which were detected by ultrasonography and 37 of which were detected by chest radiography. The 97.5% sensitivity and 99.7% specificity observed for thoracic ultrasonography were similar to the 92.5% sensitivity and 99.7% specificity for portable chest radiography. Performance time for ultrasonography was significantly faster than that for chest radiography (1.30 +/- 0.08 vs. 14.18 +/- 0.91 minutes, p < 0.0001).


CONCLUSIONS
Surgeons can accurately perform and interpret a focused thoracic ultrasonographic examination to detect traumatic effusion. Surgeon-performed thoracic ultrasonography is as accurate but is significantly faster than supine portable chest radiography for the detection of traumatic effusion.
Sisley
A C
AC
University of Arizona Health Sciences Center, Tucson 85724, USA.
Rozycki
G S
GS
Ballard
R B
RB
Namias
N
N
Salomone
J P
JP
Feliciano
D V
DV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D013502:General Surgery; D006801:Humans; D007223:Infant; D008875:Middle Aged; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D013909:Thorax / Q000000981:diagnostic imaging*; D014463:Ultrasonography