The Role of Sonography in the Emergency Room for the Diagnosis of Thoracic Trauma

Abstract

Introduction: Within care for the injured patient with thoracic trauma there are several diagnostic means. For example, extended focused assessment with sonography for thoracic trauma has shown high sensitivity, even when performed by non-radiologists such as general surgeons, emergency specialists and intensivists.

Objective: To determine the usefulness of extended thoracic sonography performed by surgeons on injured patients with thoracic trauma.

Methods: An observational, descriptive and cross-sectional study of diagnostic tests assessment was carried out in 1052 patients admitted to the emergency room. They were assessed by extended thoracic sonography at General Calixto García University Hospital, during the period between January 2020 and February 2021.

Results: A total of 1052 thoracic ultrasounds were performed in a period of one year, of which 221 cases were positive. Of them, 81 were pneumothorax (7.7%) and 62 were hemopneumothorax (5.9%), all confirmed by chest tomography. The average age was 45.27 (18-97). The male sex prevailed, with 772 cases (73.4%). The most frequent trauma-producing mechanisms were altitude fall, accounting for 273 cases (26%), and blunt trauma, accounting for 181 cases (17.2%). Extended thoracic ultrasound showed a sensitivity of 95.24% and a specificity of 99.88% in the diagnosis of thoracic injuries.

Conclusions: Extended thoracic ultrasound showed that, in the hands of general surgeons, it is a reliable, safe, noninvasive, inexpensive and repeatable tool that allows rapid diagnosis and treatment of thoracic injuries.

Keywords: thoracic trauma; thorax sonography, pneumothorax; hemothorax.