title: Feasibility of emergency department point-of-care ultrasound for rib fracture diagnosis in minor thoracic injury.
abstract: OBJECTIVE
  The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results.
  
  
  METHODS
  Adult patients who presented with clinical suspicion of rib fractures after mTI were included. All patients underwent PoCUS performed by emergency physicians (EPs) prior to a rib view X-ray. A visual analogue scale (VAS) ranging from 0 to 100 was used to ascertain feasibility, patients' pain and clinicians' degree of certitude. Feasibility was defined as a score of more than 50 on the VAS. We documented the radiologists' interpretation of rib view X-ray. Radiologists were blinded to the PoCUS results.
  
  
  RESULTS
  Ninety-six patients were included. A majority (65%) of EPs concluded that the PoCUS technique to diagnose rib fracture was feasible (VAS score > 50). Median score for feasibility was 63. Median score was 31 (Interquartile range [IQR] 5-57) for patients' pain related to the PoCUS. The main limiting factor of the PoCUS technique was pain during patient examination (15%).
  
  
  CONCLUSIONS
  PoCUS examination appears to be a feasible technique for a rib fracture diagnosis in the ED.
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Élizabeth
authors.initials: É
authors.lastname: Lalande
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Chantal
authors.initials: C
authors.lastname: Guimont
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Marcel
authors.initials: M
authors.lastname: Émond
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Marc Charles
authors.initials: MC
authors.lastname: Parent
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Claude
authors.initials: C
authors.lastname: Topping
authors.affiliation: ‡Centre de recherche du CHU de Québec,Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en Traumatologie - Urgence - Soins Intensifs,Quebec,QC.
authors.forename: Brice Lionel Batomen
authors.initials: BLB
authors.lastname: Kuimi
authors.affiliation: ‡Centre de recherche du CHU de Québec,Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en Traumatologie - Urgence - Soins Intensifs,Quebec,QC.
authors.forename: Valérie
authors.initials: V
authors.lastname: Boucher
authors.affiliation: *Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Quebec,QC.
authors.forename: Natalie
authors.initials: N
authors.lastname: Le Sage
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011792:Quebec; D013902:Radiography, Thoracic / Q000379:methods; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D018608:Ultrasonography, Doppler
keywords: Rib fracture; minor thoracic injury; point-of-care ultrasound