Abstract
Background: Blunt thoracic and abdominal traumas are frequent and have a poor prognosis in the absence of prompt diagnosis and adequate management. An ultrasound performed in the emergency room allows a precise diagnosis and a better orientation of the victims. Objective: To assess the contribution of EFAST ultrasound in the management of blunt thoracic and abdominal traumas. Patients and method: Cross-sectional descriptive and analytical study with prospective data collection carried out from February 20th to August 20th, 2017 in the emergency and intensive care units of the Parakou University Hospital Centre. An ultrasound machine fitted with a 3.5 MHz convex probe was used to search for post-traumatic effusion by the EFAST technique on admission and then as needed over 24 hours and after surgery. Results: Sixty-three patients were collected with an 85.71% male predominance. The average age was 31.36 ± 13.29 years. The time to perform the EFAST ultrasound was 7 ± 3 min. EFAST was positive in 50.79% of patients. Five patients (7.93%) received emergency treatment for hemodynamic instability and positive EFAST within an average of 3.46 ± 2 hours. Eighteen patients (27.58%) received after monitoring by EFAST, surgery within 9 hours 12 minutes (hemoperitoneum) and 27 hours 58 minutes (hemothorax). Two patients were tested positively for EFAST after surgery. Conclusion: The introduction of an EFAST ultrasound as a sorting tool in an environment with limited resources is desirable and feasible.
Highlights
Chest and abdomen injuries are recurrent and represent a major cause of morbidity and mortality [1] [2]. 20% to 25% of trauma victims die of thoracic injuries [3]
Frequency During the study period, 1331 patients were admitted to the emergency department
We counted 546 trauma patients (41.02%) among which 63 cases of closed trauma related to thorax and abdomen were collected, representing 11.53% of admissions and divided into 14 thorax related trauma patients (22.22%), 20 abdominal trauma (31.75%) and 29 thoraco-abdominal trauma (46.03%)
Summary
Chest and abdomen injuries are recurrent and represent a major cause of morbidity and mortality [1] [2]. 20% to 25% of trauma victims die of thoracic injuries [3]. The creation and performance of pre-hospital medicine, thanks to the Emergency Medical Assistance Service (SAMU), revolutionized trauma patients care [6]. Several attempts at standardization have led to the development of a protocol: FAST (Focussed Abdominal Sonography for Trauma patients) [12]. This is a protocol for coding emergency ultrasound for trauma patients, especially abdominal, in a synthetic, oriented and simple way. Objective: To assess the contribution of EFAST ultrasound in the management of blunt thoracic and abdominal traumas. Five patients (7.93%) received emergency treatment for hemodynamic instability and positive EFAST within an average of 3.46 ± 2 hours. Conclusion: The introduction of an EFAST ultrasound as a sorting tool in an environment with limited resources is desirable and feasible
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