Emergency Medicine

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Browsing Emergency Medicine by Subject "Abdominal trauma patients,intraperitoneal free fluid collection"

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    Utilization of Diagnostic FAST US in detecting free intraperitoneal free fluid collection for abdominal trauma patients done in TASH ED, Addis Ababa, Ethiopia, 20172018
    (Addis Abeba University, 2018) Yehualaeshet, Tinbit; Prof.Azazh, Aklilu( MD,Professor of Emergency Medicine); Dr.Girma, Bruk(M.D.Emergency Medicine and critical care)
    INTRODUCTION- Ultrasound has emerged as an alternative means of evaluating patients who sustained blunt abdominal injury. As a screening tool for evaluating the presence of intra peritoneal fluid because it is quick, non-invasive, repeatable, and inexpensive and entails no radiation. Ultrasound machines are also portable so that it could be taken to the unstable patient’s bedside for continuous monitoring 0. It also shows the amount and extent of intraperitoneal hemorrhage. OBJECTIVE- This study will generally asses the utilization of FAST in abdominal trauma patients and the diagnostic accuracy in intra-op findings and to validate the use of FAST US in all abdominal trauma patients. METHODS AND MATERIALS- This is a prospective cross sectional study to assess the utilization of bedside FAST US and the diagnostic accuracy of bedside FAST US in detecting intraperitoneal collection for patients presenting to the TASH ED with abdominal trauma and who are hemodynamically stable or unstable. FAST performed by emergency medicine senior (R3) residents or attending emergency physicians in the ED will be taken and compared with the results of formal ultrasound, CT scan or intra-op findings. RESULTS- 40 patients were included in this study and 75% of them were from the working class and 7.5% of them were students accounting for more than a third of all patients. Most of this patients came from Oromiya region (57.5%) and Addis Ababa(20%). 70% of the patients had normal blood pressure measurement, where as 55% of them were Tachycardic and 27.5% were Tachypneic. Only 2(5%) of patients presented with GCS of <8. Majority of the patients 39(97.5%) had blunt abdominal trauma and only one patient presented with penetrating abdominal trauma and was taken to the OR immediately. Polytrauma was the most encountered associated injury accounting for 14(35%) of patients. The sensitivity and specificity of the FAST scan were 100% and 86%, respectively. The negative predictive value was 1, while the positive predictive value was 0.73.CONCLUSION- This study shows that FAST scanning for abdominal trauma patients is a good screening method for intraperitoneal fluid collection, hence valuable to rule out abdominal solid organ injury and bleeding. Therefore we recommend the use of FAST ultrasound in all abdominal injury patients.