Study on rapid assessment of severe trauma patients in ICU by clinician-performed ultrasound

Objective To investigate the clinical significance and feasibility of performing ultrasound by clinicians for rapid assessment of severe trauma patients in ICU.Methods Totally 148 severe trauma patients admitted to emergency ICU were enrolled,and bedside sonography focused on chest,abdomen and pericardium were performed by qualified ICU doctors.It was judged as positive when gas or free fluid was detected in thoracic cavity,abdomen or pericardium.The clinical result confirmed by CT scan,operation and follow-up was regarded as a golden standard.Then the values of sonography performed by clinicians were compared with that performed by ultrasound doctors.Results The result of sonography performed on the 148 patients showed that pleural effusion was positive in 45 patients,pneumothorax in 16 patients,pericardial effusion in 6 patients and ascites in 24 patients.And pleural effusion was false negative in 2 patients,pneumothorax in 4 patients,pericardial effusion in 1 patient and ascites in 4 patients respectively.There was no significant difference between the result of sonography performed by clinicians and that performed by ultrasound doctors in the evaluation of free fluid in splanchnocoel and pericardium(P0.05).There was also no significant difference in sensitivity,specificity and accuracy(P0.05).The sensitivity,specificity and accuracy in the diagnosis of pneumothorax by clinician-performed ultrasound was 80.0%,100% and 97.3% respectively.Conclusion After proper training,clinicians can perform rapid assessment of the pleural,peritoneal and pericardial cavity by ultrasound in severe trauma patients with higher accuracy and convenience,and therefore it deserves further application in trauma care.