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Impact of Point-of-Care Ultrasound on Secondary Triage: A Pilot Study

Published online by Cambridge University Press:  01 April 2022

Riccardo Stucchi
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Eric S. Weinstein
Affiliation:
Research Centre in Emergency and Disaster Medicine (CRIMEDIM), Universita‘ del Piemonte Orientale, Novara, Italy
Alba Ripoll-Gallardo*
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy Research Centre in Emergency and Disaster Medicine (CRIMEDIM), Universita‘ del Piemonte Orientale, Novara, Italy
Jeffrey M. Franc
Affiliation:
Research Centre in Emergency and Disaster Medicine (CRIMEDIM), Universita‘ del Piemonte Orientale, Novara, Italy Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
Massimo Azzaretto
Affiliation:
Fondazione Poliambulanza Istituto Ospedaliero Polispecialistico, Brescia, Italy
Giovanni Sesana
Affiliation:
SSD Banca dei tessuti e terapia tissutale, Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Francesco Della Corte
Affiliation:
Research Centre in Emergency and Disaster Medicine (CRIMEDIM), Universita‘ del Piemonte Orientale, Novara, Italy
Luca Neri
Affiliation:
ATS Milan, Italy
*
Corresponding author: Alba Ripoll-Gallardo, Email alba.ripoll@med.uniupo.it.

Abstract

Objectives:

In mass casualty scenarios, patients with apparent hemodynamic and respiratory stability might have occult life-threatening injuries. These patients could benefit from more accurate triage methods. This study assessed the impact of point-of-care ultrasound on the accuracy of secondary triage conducted at an advanced medical post to enhance the detection of patients who, despite their apparent clinically stable condition, could benefit from earlier evacuation to definitive care or immediate life-saving treatment.

Methods:

A mass casualty simulated event consisting of a bomb blast in a remote area was conducted with 10 simulated casualties classified as YELLOW at the primary triage scene; patients were evaluated by 4 physicians at an advanced medical post. Three patients had, respectively, hemoperitoneum, pneumothorax, and hemothorax. Only 2 physicians had sonographic information.

Results:

All 4 physicians were able to suspect hemoperitoneum as a possible critical condition to be managed first, but only physicians with additional sonographic information accurately detected pneumothorax and hemothorax, thus deciding to immediately evacuate or treat.

Type
Brief Report
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Bouzat, P, Ageron, FX, Brun, J, et al. A regional trauma system to optimize the pre-hospital triage of trauma patients. Crit Care. 2015;19(1):111.CrossRefGoogle ScholarPubMed
Kahn, C, Lerner, E, Triage, Cone D.. In Koenig, K, Schultz, C, eds. Disaster Medicine: Comprehensive Principles and Practices. Cambridge University Press; 2016:208-218.Google Scholar
Frykberg, ER. Triage: principles and practice. Scand J Surg. 2005;94(4):272-278.CrossRefGoogle ScholarPubMed
Sajed, D. The history of point-of-care ultrasound use in disaster and mass casualty incidents. Virtual Mentor. 2010;12(9):744-749.Google ScholarPubMed
Neri, L, Storti, E, Lichtenstein, D. Toward an ultrasound curriculum for critical care medicine. Crit Care Med. 2007;35(5 Suppl):S290-S304.CrossRefGoogle ScholarPubMed
Ketelaars, R, Reijnders, G, van Geffen, GJ, et al. ABCDE of prehospital ultrasonography: a narrative review. Crit Ultrasound J. 2018;10(1):17.CrossRefGoogle ScholarPubMed
Professional curriculum for emergency physicians. (In Italian.) Accessed on February 8, 2021. http://www.miur.it/userfiles/2292.pdf Google Scholar
Sztajnkrycer, MD, Baez, AA, Luke, A. FAST Ultrasound as an adjunct to triage using the START mass casualty triage system. Prehosp Emerg Care. 2006;10(1):96-102.CrossRefGoogle ScholarPubMed
Teixeira, PG, Inaba, K, Hadjizacharia, P, et al. Preventable or potentially preventable mortality at a mature trauma center. J Trauma. 2007;63(6):1338-1346.Google ScholarPubMed
Davis, JW, Hoyt, DB, McArdle, MS, et al. The significance of critical care errors in causing preventable death in trauma patients in a trauma system. J Trauma. 1991;31(6):813-818.CrossRefGoogle Scholar
Paddock, MT, Bailitz, J, Horowitz, R, et al. Disaster response team FAST Skills training with a portable ultrasound simulator compared to traditional training: pilot study. West J Emerg Med. 2015;16:325-330.CrossRefGoogle Scholar
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