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Actual literature has demonstrated that prehospital extended focused assessment sonography for trauma (eFAST) could impact on logistic and treatment decisions such as mode of transportation and choice of hospital destination.
However, there are no data with regard to in-hospital effects of a positive prehospital eFAST.
The main objective of this study was to evaluate the effects of prehospital eFAST driven decisions on in hospital time-to-definitive diagnostics or time-to definitive treatment, whichever came first, in a level 1 trauma center.
The goal is to define if this information could have a role in prioritizing patients' access to care in a population of abdominal trauma patients with A-AIS > 1 and a documented liver or spleen injury.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Positive prehospital eFAST | Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs |
| |
| Negative or not performed prehospital eFAST | Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| prehospital extended focused assessment sonography for trauma | Diagnostic Test | Sonographic procedure performed in the prehospital environment aiming at evaluating peritoneal free fluid in trauma patients |
| Measure | Description | Time Frame |
|---|---|---|
| Time to definitive diagnostics or treatment | Time from the ED arrival to CT scan imaging or surgical intervention (whichever came first) | 180 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Prehospital time | Time from EMS dispatch to ED arrival | 240 minutes |
| Sensitivity and specificity of prehospital eFAST | Sensitivity and specificity of prehospital eFAST calculated considering ED eFAST as the gold standard measure |
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Inclusion Criteria:
Exclusion Criteria:
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This study will involve all the patients admitted to the Maggiore Hospital's emergency department (ED) from January 2014 to December 2019 with a traumatic liver or spleen injury who survived enough time to get a CT scan or a surgical intervention within 3 hours from the ED admission
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maggiore Hospital Ospedale Maggiore Carlo Alberto Pizzardi AUSL di Bologna | Bologna | 40110 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29940990 | Background | Botker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma Resusc Emerg Med. 2018 Jun 26;26(1):51. doi: 10.1186/s13049-018-0518-x. | |
| 31349348 | Background | Chang R, Kerby JD, Kalkwarf KJ, Van Belle G, Fox EE, Cotton BA, Cohen MJ, Schreiber MA, Brasel K, Bulger EM, Inaba K, Rizoli S, Podbielski JM, Wade CE, Holcomb JB; PROPPR Study Group. Earlier time to hemostasis is associated with decreased mortality and rate of complications: Results from the Pragmatic Randomized Optimal Platelet and Plasma Ratio trial. J Trauma Acute Care Surg. 2019 Aug;87(2):342-349. doi: 10.1097/TA.0000000000002263. |
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|
| 240 minutes |
| 11901314 | Background | Clarke JR, Trooskin SZ, Doshi PJ, Greenwald L, Mode CJ. Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes. J Trauma. 2002 Mar;52(3):420-5. doi: 10.1097/00005373-200203000-00002. |
| 29628662 | Background | El Zahran T, El Sayed MJ. Prehospital Ultrasound in Trauma: A Review of Current and Potential Future Clinical Applications. J Emerg Trauma Shock. 2018 Jan-Mar;11(1):4-9. doi: 10.4103/JETS.JETS_117_17. |
| 20124905 | Background | Jorgensen H, Jensen CH, Dirks J. Does prehospital ultrasound improve treatment of the trauma patient? A systematic review. Eur J Emerg Med. 2010 Oct;17(5):249-53. doi: 10.1097/MEJ.0b013e328336adce. |
| ID | Term |
|---|---|
| D000007 | Abdominal Injuries |
| D014947 | Wounds and Injuries |
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