title: The place of thoracic abdominal ultrasound influencing survival of patients in traumatic cardiac arrest imminence.
abstract: Severe trauma has become the most frequent cause of death in industrialized countries and, for this reason, the fastness of a diagnostic approach and the precocity of the proper treatment are both essential and best influenced by the trauma team collaboration and the existence of a specific algorithm in which each specialist has a definite place and role. In the first stage time of a proposed specific algorithm, the vital stage, which covers the primary survey, the trauma team has not more than 5 min. (ideally) to complete airway, breathing, circulation lesions with vital potential. The ultrasound exam is placed in this stage, which is nothing more than a completion of the primary survey maneuvers, which are exclusively clinical. Two groups of patients were compared in our study; one which was named A, represented by severe traumatized patients admitted between January 2003 and December 2006 and the other one which was named B, with severe traumatized patients admitted between January 2007 and December 2012. The second group was treated by using the modified algorithm. Although the differences were not statistically significant because of the small number of survivors, the modified algorithm was evidently superior in patients with and without cardiac arrest. If we take into account that 48 of the 261 patients survived a cardiac arrest event (although only 9 of them were discharged), the advantages of this type of algorithm are even more obvious. In lot A, 21 patients survived a cardiac arrest, of whom only 4 were discharged. Performing an ultrasound examination during the first step of the algorithm used in the study is essential regardless of trauma causes, particularly hypovolemia. For both groups of patients with and without cardiac arrest, the percentage of patients who received ultrasound increased in the group that received a modified algorithm.
authors.affiliation: Department of Anaesthesia and Intensive Care, "Carol Davila" Nephrology Hospital, Bucharest, Romania.
authors.forename: V
authors.initials: V
authors.lastname: Georgescu
authors.affiliation: Department of Anaesthesia and Intensive Care, "Carol Davila" Nephrology Hospital, Bucharest, Romania.
authors.forename: O
authors.initials: O
authors.lastname: Tudorache
authors.affiliation: Department of Anaesthesia and Intensive Care, "Agrippa Ionescu" Emergency Hospital, Bucharest, Romania.
authors.forename: M
authors.initials: M
authors.lastname: Nicolau
authors.affiliation: Department of Anaesthesia and Intensive Care, "Carol Davila" Nephrology Hospital, Bucharest, Romania.
authors.forename: G
authors.initials: G
authors.lastname: Gugonea
authors.affiliation: Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: V
authors.initials: V
authors.lastname: Strambu
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D016019:Survival Analysis; D013909:Thorax / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014947:Wounds and Injuries / Q000150:complications*
keywords: algorithm; severe trauma; thoracic abdominal ultrasound; traumatic cardiac arrest