Surgeon-performed ultrasound for pneumothorax in the trauma suite.
BACKGROUND
Surgeon-performed ultrasound has become ubiquitous in the trauma suite. Initial reports suggest that sonography may be used for the detection of pneumothorax. The purpose of this study was to evaluate the efficacy of sonography to rule out the presence of a pneumothorax in the trauma population.


METHODS
A prospective analysis of 328 consecutive trauma patients at an American College of Surgeons-verified Level I trauma center was undertaken. Thoracic ultrasound was performed before chest radiography. The presence or absence of a "sliding-lung" sign or "comet-tail" artifact was recorded.


RESULTS
Of 328 evaluations, there were 312 true-negatives, 12 true-positives, 1 false-negative, 1 false-positive, and 2 exclusions. Specificity, negative predictive value, and accuracy were 99.7%, 99.7%, and 99.4%, respectively.


CONCLUSIONS
Ultrasound is a reliable modality for the diagnosis of pneumothorax in the injured patient. This modality may serve as an adjunct or precursor to routine chest radiography in the evaluation of injured patients.
Knudtson
Jason L
JL
Department of Surgery, University of Kansas School of Medicine-Wichita, Room 3082, 929 North St. Francis, Wichita, KS 67214-3199, USA.
Dort
Jonathan M
JM
Helmer
Stephen D
SD
Smith
R Stephen
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D002648:Child; D002675:Child, Preschool; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007396:Internship and Residency; D007615:Kansas; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010348:Patient Care Team; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D014193:Trauma Centers; D018616:Ultrasonography, Doppler, Duplex / Q000706:statistics & numerical data