ArticleJAMA network open2022
Appropriateness of Initial Course of Action in the Management of Blunt Trauma Based on a Diagnostic Workup Including an Extended Ultrasonography Scan.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guidance for performance, utilization, and education of cardiac and lung point-of-care ultrasonography from the Japanese Society of Echocardiography.Journal of echocardiography · 2024Guideline
- Ultrasonography in disaster medicine: a narrative review.Insights into imaging · 2026Article
- International evidence-based recommendations for point-of-care lung ultrasound : 2025 focused update of the 2012 recommendations.Intensive care medicine · 2026Article
- Successful treatment of recurrent traumatic cardiac arrest due to splenic rupture in trauma resuscitation unit: a case report.Frontiers in medicine · 2025Article
- Accuracy between prehospital and hospital diagnosis in helicopter emergency medical services and its consequences for trauma care.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Automated detection and segmentation of pleural effusion on ultrasound images using an Attention U-net.Journal of applied clinical medical physics · 2024Article
- The forgotten cohort-lessons learned from prehospital trauma death: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Importance: The extended Focused Assessment With Sonography for Trauma (E-FAST) has become a cornerstone of the diagnostic workup in patients with trauma. The added value of a diagnostic workup including an E-FAST to support decision-making remains unknown. Objective: To determine how often an immediate course of action adopted in the resuscitation room based on a diagnostic workup that included an E-FAST and before whole-body computed tomography scanning (WBCT) in patients with blunt trauma was appropriate. Design, Setting, and Participants: This cohort study was conducted at 6 French level I trauma centers between November 5, 2018, and November 5, 2019. Consecutive patients treated for blunt trauma were assessed at the participating centers. Data analysis took place in February 2022. Exposures: Diagnostic workup associating E-FAST (including abdominal, thoracic, pubic, and transcranial Doppler ultrasonography scan), systematic clinical examination, and chest and pelvic radiographs. Main Outcomes and Measures: The main outcome criterion was the appropriateness of the observed course of action (including abstention) in the resuscitation room according to evaluation by a masked expert panel. Results: Of 515 patients screened, 510 patients (99.0%) were included. Among the 510 patients included, 394 were men (77.3%), the median (IQR) age was 46 years (29-61 years), and the median (IQR) Injury Severity Score (ISS) was 24 (17-34). Based on the initial diagnostic workup, no immediate therapeutic action was deemed necessary in 233 cases (45.7%). Conversely, the following immediate therapeutic actions were initiated before WBCT: 6 emergency laparotomies (1.2%), 2 pelvic angioembolisations (0.4%), 52 pelvic binders (10.2%), 41 chest drains (8.0%) and 16 chest decompressions (3.1%), 60 osmotherapies (11.8%), and 6 thoracotomies (1.2%). To improve cerebral blood flow based on transcranial doppler recordings, norepinephrine was initiated in 108 cases (21.2%). In summary, the expert panel considered the course of action appropriate in 493 of 510 cases (96.7%; 95% CI, 94.7%-98.0%). Among the 17 cases (3.3%) with inappropriate course of action, 13 (76%) corresponded to a deviation from existing guidelines and 4 (24%) resulted from an erroneous interpretation of the E-FAST. Conclusions and Relevance: This prospective, multicenter cohort study found that a diagnostic resuscitation room workup for patients with blunt trauma that included E-FAST with clinical assessment and targeted chest and pelvic radiographs was associated with the determination of an appropriate course of action prior to WBCT.
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