Emergency trauma ultrasonography in detecting free fluid in patients with blunt thoracoabdominal trauma

Introduction: Trauma, which is an important cause of mortality; It is the leading cause of youth death worldwide. It is aimed to reduce the damage of trauma with the protocols to present in the emergency department. Ultrasonography is preferred in trauma because it is applied at the bedside and fast. In this study, we aimed to evaluate the effectiveness of emergency trauma ultrasonography in detecting free fluid in patients with blunt thoraco-abdominal trauma. Materials and methods: This study was carried out in Akdeniz University Hospital Emergency Department between September 2018 and September 2020. Patients admitted to the emergency department as an outpatient or brought by 112 emergency ambulances were included. This study was conducted retrospectively. Adult patients with blunt trauma who underwent abdominal computed tomography (CT) were included in the study. Patients; Sonographic examination (FAST and conventional USG) and computed tomography (CT) results performed by emergency medicine physicians and radiology physicians were recorded separately for each sonographic scanning area. Results: Of the 310 patients followed in this study; 59 of them were women. The mean age of the patients was 43,6±17.87 years. 56.45% of the patients were transported to the hospital within 1 hour after the trauma, and 92.6% were injured as a result of blunt trauma. Sensitivity and specificity for FAST by scan areas; hepatorenal area (60.34% vs. 97.22%), splenorenal area (64.41% vs. 98.8%), and pelvic area (40.63% vs 99.59%). When evaluated independent of the scanning area, its sensitivity was 47.47%, while its specificity was 97.94% compared to CT. For conventional USG, these values were observed as 48.28% and 97.42%, respectively. FAST success did not change according to the time of admission (p=0.51). Discussions: FAST has the highest sensitivity in the detection of peritoneal free fluid in the pelvic area, and the highest specificity in the hepatorenal area scan. Compared with CT, it has similar sensitivity and specificity as conventional USG. Keywords: Emergency Department, Trauma, Ultrasonography