PMID- 23599841
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130422
LR  - 20211021
IS  - 1936-900X (Print)
IS  - 1936-9018 (Electronic)
IS  - 1936-900X (Linking)
VI  - 14
IP  - 2
DP  - 2013 Mar
TI  - Clinician-performed Beside Ultrasound for the Diagnosis of Traumatic 
      Pneumothorax.
PG  - 103-8
LID - 10.5811/westjem.2012.12.12663 [doi]
AB  - INTRODUCTION: Prior studies have reported conflicting results regarding the 
      utility of ultrasound in the diagnosis of traumatic pneumothorax (PTX) because 
      they have used sonologists with extensive experience. This study evaluates the 
      characteristics of ultrasound for PTX for a large cohort of trauma and emergency 
      physicians. METHODS: This was a prospective, observational study on a convenience 
      sample of patients presenting to a trauma center who had a thoracic ultrasound 
      (TUS) evaluation for PTX performed after the Focused Assessment with Sonography 
      for Trauma exam. Sonologists recorded their findings prior to any other 
      diagnostic studies. The results of TUS were compared to one or more of the 
      following: chest computed tomography, escape of air on chest tube insertion, or 
      supine chest radiography followed by clinical observation. RESULTS: There were 
      549 patients enrolled. The median injury severity score of the patients was 5 
      (inter-quartile range [IQR] 1-14); 36 different sonologists performed TUS. 
      Forty-seven of the 549 patients had traumatic PTX, for an incidence of 9%. TUS 
      correctly identified 27/47 patients with PTX for a sensitivity of 57% (confidence 
      interval [CI] 42-72%). There were 3 false positive cases of TUS for a specificity 
      of 99% (CI 98%-100%). A "wet" chest radiograph reading done in the trauma bay 
      showed a sensitivity of 40% (CI 23-59) and a specificity of 100% (99-100). 
      CONCLUSION: In a large heterogenous group of clinicians who typically care for 
      trauma patients, the sonographic evaluation for pneumothorax was as accurate as 
      supine chest radiography. Thoracic ultrasound may be helpful in the initial 
      evaluation of patients with truncal trauma.
FAU - Ku, Bon S
AU  - Ku BS
AD  - Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, 
      Pennsylvania.
FAU - Fields, J Matthew
AU  - Fields JM
FAU - Carr, Brendan
AU  - Carr B
FAU - Everett, Worth W
AU  - Everett WW
FAU - Gracias, Vincent H
AU  - Gracias VH
FAU - Dean, Anthony J
AU  - Dean AJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - West J Emerg Med
JT  - The western journal of emergency medicine
JID - 101476450
PMC - PMC3628453
EDAT- 2013/04/20 06:00
MHDA- 2013/04/20 06:01
PMCR- 2013/03/01
CRDT- 2013/04/20 06:00
PHST- 2012/05/25 00:00 [received]
PHST- 2012/10/12 00:00 [revised]
PHST- 2012/12/10 00:00 [accepted]
PHST- 2013/04/20 06:00 [entrez]
PHST- 2013/04/20 06:00 [pubmed]
PHST- 2013/04/20 06:01 [medline]
PHST- 2013/03/01 00:00 [pmc-release]
AID - wjem-14-103 [pii]
AID - 10.5811/westjem.2012.12.12663 [doi]
PST - ppublish
SO  - West J Emerg Med. 2013 Mar;14(2):103-8. doi: 10.5811/westjem.2012.12.12663.