Advertisement

Journal of Ultrasound

, Volume 20, Issue 2, pp 171–177 | Cite as

Ultrasound as point of care in management of polytrauma and its complication

  • Saverio LatteriEmail author
  • Giulia Malaguarnera
  • Maurizio Mannino
  • Antonio Pesce
  • Giuseppe Currò
  • Stefania Tamburrini
  • Mario Scuderi
Case Report

Abstract

Purpose

Traumatic injuries constitute a major risk for patients in emergency units. Point-of-care ultrasound may be a determinant in reducing the deleterious impact of complications and in prognosis.

Methods

We describe the case of a 28-year-old female who reported cranial trauma, abdominal and thoracic trauma, and suspected bilateral fracture of the femur.

Results

Ultrasound was useful for evaluating and monitoring multiple organ failure.

Conclusion

Combining cost-effective advantages with bedside real-time imaging, ultrasound is a powerful adjunct to standard clinical assessment in the management of polytrauma when it is administered at the point of care.

Keywords

Trauma Ultrasound Cost benefits Emergency 

Sommario

Scopo

le patologie traumatiche rappresentano il maggiore rischio dei pazienti nelle Unità di Emergenza. L’ecografia consentendo una diagnosi precoce sia del tipo di trauma sia delle complicanze che da questo potrebbero derivane, può rappresentare un mezzo importante per la prognosi e per l’eventuale terapia.

Metodi

A tale scopo, noi presentiamo un caso paradigmatico di una paziente di 28 anni che, a seguito di un incidente, aveva riportato dei traumi al cranio, all’addome e al torace e sospetta frattura bilaterale al femore. Al momento del ricovero la paziente era monitorizzata tramite ecografia. I dati venivano confermati sia dalla sintomatologia clinica obiettiva, sia dalla tomografia assiale computerizzata.

Risultato

l’uso dell’ecografia ha consentito una diagnosi precoce non solo del tipo di trauma, ma anche ha permesso un corretto intervento terapeutico ed un monitoraggio anche dell’attività cardiaca.

Conclusione

L’ecografia presenta vantaggi dal punto di vista costo-beneficio ed è utile sia ai fini diagnostici, sia ai fini terapeutici.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Consent for publication

The patient included in this study signed consensus form to publish the data collected. All sensitive data were collected and protected in respect of present privacy statements.

References

  1. 1.
    La Greca G, Gagliardo S, Sofia M, Barbagallo F, Chisari A, Latteri S, Pontillo T, Politi A, Russello D (2008) Perineo-ano-rectal injuries: clinical experience. Chir Ital. 60(1):91–101PubMedGoogle Scholar
  2. 2.
    Corso P, Finkelstein E, Miller T, Fiebelkorn I, Zaloshnja E (2015) Incidence and lifetime costs of injuries in the United States. Inj Prev. 21(6):434–440. doi: 10.1136/ip.2005.010983rep CrossRefPubMedGoogle Scholar
  3. 3.
    Blanco P (2015) A traditional paradigm vs. an ultrasound-supported paradigm in emergency and critical care medicine: a crisis of the mind is needed. J Emerg Med 49(2):e63–e64. doi: 10.1016/j.jemermed.2015.02.045 CrossRefPubMedGoogle Scholar
  4. 4.
    Blanco P, Aguiar FM, Vallejo A (2016) Point-of-care ultrasonography in critical care medicine: a one way directional road. J Ultrasound. 19(2):157–158. doi: 10.1007/s40477-015-0192-z (eCollection 2016) CrossRefPubMedGoogle Scholar
  5. 5.
    Scuderi M (2008) Ecografia clinica nelle urgenze-emergenze. Edizioni Minerva Medica. ISBN: 8877115920Google Scholar
  6. 6.
    Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, Turpie AG, Bormanis J, Weitz J, Chamberlain M, Bowie D, Barnes D, Hirsh J (2000) Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 83(3):416–420PubMedGoogle Scholar
  7. 7.
    Malaguarnera G, Catania VE, Francaviglia A, Malaguarnera M, Drago F, Motta M, Latteri S (2017) Lipoprotein(a) in patients with hepatocellular carcinoma and portal vein thrombosis. Aging Clin Exp Res 29(Suppl 1):185–190. doi: 10.1007/s40520-016-0653-z CrossRefPubMedGoogle Scholar
  8. 8.
    Marconi S, Pugliese L, Botti M, Peri A, Cavazzi E, Latteri S, Auricchio F, Pietrabissa A (2017) Value of 3D printing for the comprehension of surgical anatomy. Surg Endosc. doi: 10.1007/s00464-017-5457-5 PubMedGoogle Scholar
  9. 9.
    Zamboni C, Yonamine AM, Faria CE, Filho MA, Christian RW, Mercadante MT (2014) Tertiary survey in trauma patients: avoiding neglected injuries. Injury 45(Suppl 5):S14–S17. doi: 10.1016/S0020-1383(14)70014-2 CrossRefPubMedGoogle Scholar
  10. 10.
    Walcher F, Weinlich M, Conrad G, Schweigkofler U, Breitkreutz R, Kirschning T, Marzi I (2006) Prehospital ultrasound imaging improves management of abdominal trauma. Br J Surg 93(2):238–242CrossRefPubMedGoogle Scholar
  11. 11.
    Deunk J, Brink M, Dekker HM, Kool DR, Blickman JG, van Vugt AB, Edwards MJ (2010) Predictors for the selection of patients for abdominal CT after blunt trauma: a proposal for a diagnostic algorithm. Ann Surg 251(3):512–520. doi: 10.1097/SLA.0b013e3181cfd342 CrossRefPubMedGoogle Scholar
  12. 12.
    Catania VE, Vecchio M, Malaguarnera M, Madeddu R, Malaguarnera G, Latteri S (2017) Tumor lysis syndrome in an extraskeletal osteosarcoma: a case report and review of the literature. J Med Case Rep. 11(1):79. doi: 10.1186/s13256-017-1241-3 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ranga U, Kalra N, Saxena AK, Bhatia A, Sandhu MS, Duseja AK, Chawla YK, Khandelwal N (2015) Focal hepatic lesions characterisation by different sonographic techniques: a prospective analysis. J Ultrasound. 19(1):15–23. doi: 10.1007/s40477-015-0172-3 (eCollection 2016) CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ha YR, Toh HC (2016) Clinically integrated multi-organ point-of-care ultrasound for undifferentiated respiratory difficulty, chest pain, or shock: a critical analytic review. J Intensive Care. 4:54. doi: 10.1186/s40560-016-0172-1 (eCollection 2016) CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Blanco P, Volpicelli G (2016) Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians. Crit Ultrasound J. 8(1):15CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Testa A, Giannuzzi R, De Biasio V (2015) Case report: role of bedside ultrasonography in early diagnosis of myonecrosis rapidly developed in deep soft tissue infections. J Ultrasound. 19(3):217–221. doi: 10.1007/s40477-015-0155-4 (eCollection 2016) CrossRefPubMedGoogle Scholar
  17. 17.
    Frankel HL, Kirkpatrick AW, Elbarbary M et al (2015) Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients-part I: general ultrasonography. Crit Care Med. 43:2479–2502CrossRefPubMedGoogle Scholar
  18. 18.
    Levitov A, Frankel HL, Blaivas M, Kirkpatrick AW, Su E, Evans D, Summerfield DT, Slonim A, Breitkreutz R, Price S, McLaughlin M, Marik PE, Elbarbary M (2016) Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically Ill patients-part II: cardiac ultrasonography. Crit Care Med 44(6):1206–1227. doi: 10.1097/CCM.0000000000001847 CrossRefPubMedGoogle Scholar

Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2017

Authors and Affiliations

  • Saverio Latteri
    • 1
    • 7
    Email author
  • Giulia Malaguarnera
    • 2
  • Maurizio Mannino
    • 1
  • Antonio Pesce
    • 3
  • Giuseppe Currò
    • 4
  • Stefania Tamburrini
    • 5
  • Mario Scuderi
    • 6
  1. 1.Emergency Department A.O.E. Cannizzaro-Catania, U.O.C. General Surgery Cannizzaro HospitalCataniaItaly
  2. 2.Research Center “The Great Senescence”, University of CataniaCataniaItaly
  3. 3.Department of Medical and Surgical Sciences and Advanced TechnologiesPoliclinico-Vittorio Emanuele HospitalCataniaItaly
  4. 4.Department of Human PathologyUniversity of MessinaMessinaItaly
  5. 5.ASL NA1 Napoli Centre-UOC Diagnostic ImagingNaplesItaly
  6. 6.Emergency Department A.O.E. Cannizzaro-Catania, U.O.S. Diagnostic Ultrasound in Emergency-Specialist School SIUMB Urgency-EmergencyCataniaItaly
  7. 7.Operative Unit of General SurgeryCannizzaro HospitalCataniaItaly

Personalised recommendations