title: Clinical findings provide criteria to evaluate priorities of ophthalmologic intervention in conscious multiple trauma patients.
abstract: BACKGROUND
  Multiple trauma patients frequently suffer eye injuries, especially those patients with head traumas. We evaluated the accuracy of physical findings to determine the priorities of emergency ophthalmologic intervention in these patients.
  
  
  METHODS
  This study included all multiple trauma patients with ophthalmic trauma who had a GCS of 15 when they arrived at the emergency department during the period of March, 2008-March, 2009. First, we evaluated the patients according to the criteria of the study. Then, an ophthalmologist evaluated them.
  
  
  RESULTS
  From March 2008-March 2009, 306 multiple trauma patients with ocular trauma came to our ED. The sensitivity and accuracy of emergency physicians in diagnosing the priority of ophthalmologic treatment were comparable to an ophthalmologist (measure of agreement in kappa=0.967).
  
  
  CONCLUSIONS
  The ability of an emergency physician or general surgeon to determine the actual need of early ophthalmologist intervention can improve decision making and saving both time and money. Our study suggests that it is possible to determine according to clinical findings the need of the patient to have ophthalmologic intervention without referring the patient to ophthalmologist examination.
  
  
  CONCLUSIONS
  Defining specific criteria of ophthalmologic examinations can clarify the necessity of emergency ophthalmologic examination and intervention.
authors.affiliation: Road Traffic Injury Research Center, Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad
authors.initials: S
authors.lastname: Shams-Vahdati
authors.affiliation: Road Traffic Injury Research Center, Department of Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Changiz
authors.initials: C
authors.lastname: Gholipour
authors.affiliation: Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: mehran.jalilzadeh@gmail.com.
authors.forename: Mehran
authors.initials: M
authors.lastname: Jalilzadeh-Binazar
authors.affiliation: Imam Reza Hospital, Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Payman
authors.initials: P
authors.lastname: Moharamzadeh
authors.affiliation: Nikokari Hospital, Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Rana
authors.initials: R
authors.lastname: Sorkhabi
authors.affiliation: Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Respina
authors.initials: R
authors.lastname: Jalilian
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003243:Consciousness; D003657:Decision Making; D003941:Diagnostic Techniques, Ophthalmological; D004635:Emergency Medicine / Q000458:organization & administration*; D004636:Emergency Service, Hospital; D005131:Eye Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D009104:Multiple Trauma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D020221:Optic Nerve Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D009917:Orbital Fractures / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D010808:Physical Examination / Q000379:methods*; D061665:Time-to-Treatment; D015599:Trauma Severity Indices
keywords: Criteria; Eye emergency; Multiple trauma