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

Eur J Orthop Surg Traumatol. 2019 Jan;29(1):31-35. doi: 10.1007/s00590-018-2283-y. Epub 2018 Jul 31.

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.

Keywords: Blunt thoracic trauma; Emergency ultrasound; PoCUS.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Emergency Service, Hospital
  • Female
  • Hemothorax / diagnostic imaging
  • Hemothorax / etiology
  • Humans
  • Male
  • Middle Aged
  • Pneumothorax / diagnostic imaging
  • Pneumothorax / etiology
  • Point-of-Care Systems*
  • Retrospective Studies
  • Rib Fractures / diagnostic imaging*
  • Thoracic Injuries / complications
  • Thoracic Injuries / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Ultrasonography*
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / diagnostic imaging*