Utility of Abdominal Ultrasound in the Evaluation of Children With Blunt Trauma

Inclusion Criteria: * Blunt torso trauma resulting from a significant mechanism of injury * Motor vehicle collision: greater than 60 mph, ejection, or rollover * Automobile versus pedestrian/bicycle: automobile speed \> 25 mph * Falls greater than 20 feet in height * Crush injury to the torso * Physical assault involving the abdomen * Decreased level of consciousness (Glasgow Coma Scale score \< 15 or below age-appropriate behavior) in association with blunt torso trauma * Blunt traumatic event with any of the following (regardless of the mechanism): * Extremity paralysis * Multiple long bone fractures (e.g., tibia and humerus fracture) * History and physical examination suggestive of intra-abdominal injury following blunt torso trauma of any mechanism (including mechanisms of injury of less severity than mentioned above) Exclusion Criteria: * No concern for inter-abdominal injury or no planned evaluation for possible IAI * Prehospital or ED age adjusted Hypotension * Prehospital or initial ED GCS score ≤ 8 * Presence of an abdominal "seat belt sign" - continuous area of erythema/contusion completely across the lower abdomen secondary to a lap belt * Penetrating trauma: stab or gunshot wounds * Traumatic injury occurring \> 24 hours prior to the time of presentation to the ED * Transfer of the patient to the UCDMC ED from an outside facility with abdominal CT scan, diagnostic peritoneal lavage, or laparotomy previously performed * Patients with known disease processes resulting in intraperitoneal fluid including liver failure and the presence of ventriculoperitoneal shunts