Ultrasound Diagnosis of Pneumothorax in Blunt Trauma: Reply

Excerpt

Thank you for your comments. We do agree that the ultrasound operator should have passed the learning curve before participating in such a study by a proper credentialing process. One of our aims was to demonstrate the importance of the learning curve of the operators, which was clear in our discussion. In most of the studies that were included in the meta analysis [1] cited by Dr. Fikri, the chest ultrasound was done by an expert sonographer or radiologist, both of which have no role in the initial resuscitation of the multiple injury patient according to ATLS protocols, a core point of our study. Furthermore, our trauma surgeons had few hours hands-on training before the start of the blinded study; this time is exactly what is needed to be added to the ATLS course rather than to involve them in prolonged and detailed courses. The learning curve was discussed clearly in the results and discussion parts of our study. Regarding the calculation in Table 2, we are confused about what Dr. Fikri meant. We used the number of the hemithoraces having pneumothorax. In the methods section, we mentioned χ ² and student-t tests for comparison between the groups (categorical and continuous variables, respectively). This was applicable in the earlier drafts; however, the analysis was not added to the final draft except for χ ² test that was prepared for Figure. 2. …