Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 1/2019

01-01-2019 | Original Article • THORAX - TRAUMA

PoCUS evaluating blunt thoracic trauma: a retrospective analysis of 18 months of emergency department activity

Authors: Alessandro Riccardi, Maria Beatrice Spinola, Valeria Ghiglione, Marco Licenziato, Roberto Lerza

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2019

Login to get access

Abstract

Blunt thoracic injury (BTI) constitutes a common presentation in emergency department: rib fractures are the most common injuries. Chest X-ray (CXR) has a limited sensitivity to identify rib fractures. We perform this retrospective study in our emergency department collecting all patients with BTI during an 18-month period. PoCUS was performed prior to acquire CXR or CT. We evaluated 1672 patients with BTI, and we reported rib fractures in 689 patients (41.21%). PoCUS was performed in 190 patients. PoCUS in emergency medicine has an increasing role, especially in BTI, but less clear is its role in detecting ribs fracture. PoCUS seems to be an effective method for diagnosing rib fracture in patients with blunt chest trauma if collaborative and with a well-isolated trauma. We used the trick of patients’ self-positioning probe in the most painful site, and this could reduce the time and the pain of the examination.
Literature
1.
go back to reference Shields JF, Emond M, Guimont C, Pigeon D (2010) Acute minor thoracic injuries: evaluation of practice and follow-up in the emergency department. Can Fam Physician 56(3):e117–e124PubMedPubMedCentral Shields JF, Emond M, Guimont C, Pigeon D (2010) Acute minor thoracic injuries: evaluation of practice and follow-up in the emergency department. Can Fam Physician 56(3):e117–e124PubMedPubMedCentral
4.
go back to reference Rainer TH, Griffith JF, Lam E et al (2004) Comparison of thoracic ultrasound, clinical acumen, and radiography in patients with minor chest injury. J Trauma 56:1211–1213CrossRefPubMed Rainer TH, Griffith JF, Lam E et al (2004) Comparison of thoracic ultrasound, clinical acumen, and radiography in patients with minor chest injury. J Trauma 56:1211–1213CrossRefPubMed
5.
go back to reference Chardoli M, Hasan-Ghaliaee T, Akbari H et al (2013) Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma. Chin J Traumatol 16:351–354PubMed Chardoli M, Hasan-Ghaliaee T, Akbari H et al (2013) Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma. Chin J Traumatol 16:351–354PubMed
8.
go back to reference Swaid F, Peleg K, Alfici R, Olsha O, Jeroukhimov I, Givon A, Israel Trauma Group, Kessel B (2014) The severity of liver injury following blunt trauma does not correlate with the number of fractured ribs: an analysis of a national trauma registry database. Surg Today 45(7):846–850. https://doi.org/10.1007/s00595-014-0975-4 (Epub 2014 Jul 5) CrossRefPubMed Swaid F, Peleg K, Alfici R, Olsha O, Jeroukhimov I, Givon A, Israel Trauma Group, Kessel B (2014) The severity of liver injury following blunt trauma does not correlate with the number of fractured ribs: an analysis of a national trauma registry database. Surg Today 45(7):846–850. https://​doi.​org/​10.​1007/​s00595-014-0975-4 (Epub 2014 Jul 5) CrossRefPubMed
13.
go back to reference Nagarsheth K, Kurek S (2011) Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan. Am Surg 77(4):480–484PubMed Nagarsheth K, Kurek S (2011) Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan. Am Surg 77(4):480–484PubMed
14.
go back to reference Lichtenstein DA, Menu Y (1995) A bedside ultrasound sign ruling out pneumothorax in the critically ill: lung sliding. Chest 108(5):1345–1348CrossRefPubMed Lichtenstein DA, Menu Y (1995) A bedside ultrasound sign ruling out pneumothorax in the critically ill: lung sliding. Chest 108(5):1345–1348CrossRefPubMed
15.
go back to reference Blaivas M, Lyon M, Duggal S (2005) A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med 12(9):844–849CrossRefPubMed Blaivas M, Lyon M, Duggal S (2005) A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med 12(9):844–849CrossRefPubMed
16.
go back to reference Kara M, Dikmen E, Erdal HH et al (2003) Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. Eur J Cardiothorac Surg 24:608–613CrossRefPubMed Kara M, Dikmen E, Erdal HH et al (2003) Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. Eur J Cardiothorac Surg 24:608–613CrossRefPubMed
18.
go back to reference Kerr-Valentic MA, Arthur M, Mullins RJ et al (2003) Rib fracture pain and disability: can we do better? J Trauma 54:1058–1063CrossRefPubMed Kerr-Valentic MA, Arthur M, Mullins RJ et al (2003) Rib fracture pain and disability: can we do better? J Trauma 54:1058–1063CrossRefPubMed
19.
go back to reference Gordy S, Fabricant L, Ham B et al (2014) The contribution of rib fractures to chronic pain and disability. Am J Surg 207:659–662CrossRefPubMed Gordy S, Fabricant L, Ham B et al (2014) The contribution of rib fractures to chronic pain and disability. Am J Surg 207:659–662CrossRefPubMed
21.
go back to reference Dubinsky I, Low A (1997) Non-life-threatening blunt chest trauma: appropriate investigation and treatment. Am J Emerg Med 15:240–243CrossRefPubMed Dubinsky I, Low A (1997) Non-life-threatening blunt chest trauma: appropriate investigation and treatment. Am J Emerg Med 15:240–243CrossRefPubMed
22.
go back to reference Lee WS, Kim YH, Chee HK, Lee SA (2012) Ultrasonographic evaluation of costal cartilage fractures unnoticed by the conventional radiographic study and multidetector computed tomography. Eur J Trauma Emerg Surg 38:37–42CrossRefPubMed Lee WS, Kim YH, Chee HK, Lee SA (2012) Ultrasonographic evaluation of costal cartilage fractures unnoticed by the conventional radiographic study and multidetector computed tomography. Eur J Trauma Emerg Surg 38:37–42CrossRefPubMed
23.
go back to reference Griffith JF, Rainer TH, Ching AS, Law KL, Cocks RA, Metreweli C (1999) Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol 173:1603–1609CrossRefPubMed Griffith JF, Rainer TH, Ching AS, Law KL, Cocks RA, Metreweli C (1999) Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol 173:1603–1609CrossRefPubMed
24.
go back to reference Hurley ME, Keye GD, Hamilton S (2004) Is ultrasound really helpful in the detection of rib fractures? Injury 35(6):562–566CrossRefPubMed Hurley ME, Keye GD, Hamilton S (2004) Is ultrasound really helpful in the detection of rib fractures? Injury 35(6):562–566CrossRefPubMed
26.
go back to reference Turk F, Kurt AB, Saglam S (2010) Evaluation by ultrasound of traumatic rib fractures missed by radiography. Emerg Radiol 17:473–477CrossRefPubMed Turk F, Kurt AB, Saglam S (2010) Evaluation by ultrasound of traumatic rib fractures missed by radiography. Emerg Radiol 17:473–477CrossRefPubMed
Metadata
Title
PoCUS evaluating blunt thoracic trauma: a retrospective analysis of 18 months of emergency department activity
Authors
Alessandro Riccardi
Maria Beatrice Spinola
Valeria Ghiglione
Marco Licenziato
Roberto Lerza
Publication date
01-01-2019
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-018-2283-y

Other articles of this Issue 1/2019

European Journal of Orthopaedic Surgery & Traumatology 1/2019 Go to the issue