SonoKids TRAUMA chest

The objective of this study was to investigate the feasibility of using ultrasound (US) in place of portable chest x-ray (CXR) for the rapid detection of a traumatic pneumothorax (PTX) requiring urgent decompression in the trauma bay. All patients who presented as a trauma alert to a single institution from August 2011 to May 2012 underwent an extended focused assessment with sonography for trauma (FAST). The thoracic cavity was examined using four-view US imaging and were interpreted by a chief resident (Postgraduate Year 4) or attending staff...

OBJECTIVE: To determine the sensitivity of emergency department ultrasonography (US) in the diagnosis of occult cardiac injuries. BACKGROUND: Internationally, US has become the investigation of choice in screening patients for a possible cardiac injury after penetrating chest trauma by detecting blood in the pericardial sac. METHODS: Patients presenting with a penetrating chest wound and a possible cardiac injury to the Groote Schuur Hospital Trauma Centre between October 2001 and February 2009 were prospectively evaluated...

OBJECTIVES: Limited transthoracic echocardiography (LTTE) has been introduced as a hemodynamic tool for trauma patients. The aim of this study was to evaluate the utility of LTTE during the evaluation of nonsurviving patients who presented to the trauma bay with traumatic cardiac arrest. METHODS: Approval by the Institutional Review Board was obtained. All nonsurviving patients with traumatic cardiac arrest who reached the trauma bay were evaluated retrospectively for 1 year...

BACKGROUND: Chest x-rays (CXRs) have been the mainstay for the management of thoracostomy tubes (TTs), but reports that ultrasound (US) may be more sensitive for detection of pneumothorax (PTX) continue to increase. The objective of this study was to determine if US is safe and effective for the detection of PTX following TT removal. METHODS: This was a retrospectively reviewed, prospective process improvement project involving patients who had a TT managed by the surgical team...

The contents of the thorax, although less frequently injured in children than in adults, remain a source of substantial potential morbidity and mortality in traumatized children. Disparate problems such as rib fractures, lung injury, hemothorax, pneumothorax, mediastinal injuries and others may present in isolation or in combination with one another. Knowledge of the manner in which pediatric anatomy, physiology and injury patterns change with age may expedite evaluating pediatric chest after trauma. We present the case of a 20-month-old toddler with blunt myocardial injury and pericardial tamponade diagnosed with surgeon-performed Focused Abdominal Sonography for Trauma (FAST)...

There is controversy regarding needle aspiration for primary spontaneous pneumothorax (PSP), with contradictory recommendations between the American College of Chest Physicians consensus statement (2001), which suggests that needle aspiration has little place in the management of PSP, and the British Thoracic Society guidelines (2010), which recommend that needle aspiration be attempted first for all cases of PSP where drainage is deemed necessary. Studies have shown that there is no significant difference between needle aspiration and tube thoracostomy with regard to safety, rates of immediate success, and early failure and has the advantages of decreasing pain and reducing rates of hospital admission and duration of hospital stay compared with tube thoracostomy...

A 10-year-old boy presented to the emergency department after being struck by a van while crossing the street. He complained of right side chest pain, and a chest radiography was suggestive of pulmonary contusion. The treating physician performed a bedside ultrasound that revealed a right-sided pulmonary contusion that was subsequently confirmed on computed tomography of the thorax. The sonographic features of pulmonary contusion are described, and the possible role of lung sonography in the assessment of pediatric thoracic trauma is discussed...