The Role of Prehospital eFAST in Accelerating Time to Diagnostics or Definitive Treatment in the Emergency Department

Azienda Usl di Bologna199 enrolled

Overview

Actual literature has demonstrated that prehospital extended focused assessment sonography for trauma (eFAST) could impact on logistic and treatment decisions such as mode of transportation and choice of hospital destination. However, there are no data with regard to in-hospital effects of a positive prehospital eFAST. The main objective of this study was to evaluate the effects of prehospital eFAST driven decisions on in hospital time-to-definitive diagnostics or time-to definitive treatment, whichever came first, in a level 1 trauma center. The goal is to define if this information could have a role in prioritizing patients' access to care in a population of abdominal trauma patients with A-AIS \> 1 and a documented liver or spleen injury.

Study Type

OBSERVATIONAL

Enrollment

199

Conditions

Trauma Splenic Trauma Abdomen Liver Injury

Interventions

prehospital extended focused assessment sonography for trauma

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients admitted to emergency department with a ICD-9-CM diagnosis of traumatic liver or spleen injury (codes 8640x, 8641x, 8650x, 8651x) * Abdominal AIS ≥ 2 * CT scan or operating theatre admission performed within 180 minutes from ED admission Exclusion Criteria: * Death before CT scan or OR/Angio suite admission (missing primary outcome measure) * Transferred to other hospitals before CT scan or operating room admission * Missing data

Outcomes

Primary Outcomes

Time to definitive diagnostics or treatment

Time from the ED arrival to CT scan imaging or surgical intervention (whichever came first)

Time frame: 180 minutes

Secondary Outcomes

Prehospital time

Time from EMS dispatch to ED arrival

Time frame: 240 minutes

Sensitivity and specificity of prehospital eFAST

Sensitivity and specificity of prehospital eFAST calculated considering ED eFAST as the gold standard measure