Blunt abdominal trauma with intra-abdominal bleeding is often underdiagnosed or even overlooked at trauma scenes.
Dr Walcher and colleagues compared the accuracy of physical examination and prehospital abdominal sonography for trauma to detect abdominal bleeding.
The research team conducted a prospective, multicenter study in 6 rescue centres took from 2002 to 2003, including 230 patients with suspected abdominal injury.
Later examinations in the emergency department, such as ultrasonography and/or computed tomography, were used as the reference standard.
The researchers obtained the complete protocol and follow-up in 202 patients.
The sensitivity, and specificity of prehospital focused abdominal sonography for trauma were 93%, and 99 % , respectively.
The researchers noted that the accuracy of prehospital focused abdominal sonography for trauma was 99 %.
|Prehospital focused abdominal sonography changed admittance to hospital in 22 %|
|British Journal of Surgery|
For physical examination at the scene, the team found that sensitivity was 93%, specificity was 52%, and accuracy was 57%.
The team observed that scanning with prehospital focused abdominal sonography occurred a mean of 35 minutes earlier than ultrasound in the emergency department.
Abdominal bleeding was detected in 14 % of patients.
Using prehospital focused abdominal sonography for trauma led to a change in either prehospital therapy or management in 30 % of patients.
In addition, the researchers noted that prehospital focused abdominal sonography changed admittance to hospital in 22 %.
Dr Walcher's team concludes, “In this study, prehospital focused abdominal sonography for trauma was a useful and reliable diagnostic tool when used as part of surgical triage at the trauma scene.”