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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn the decades since the Focused Assessment with Sonography in Trauma examination was first proposed, the use of point-of-care ultrasonography has expanded further into the trauma world. This article discusses the modern use of bedside ultrasonography in the initial evaluation of trauma patients.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ETrauma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EUltrasonography\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EEmergency Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ETrauma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EUltrasonography\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn the decades since the Focused Assessment with Sonography in Trauma examination was first proposed, the use of point-of-care ultrasonography has expanded further into the trauma world. Matt Dawson, MD, University of Kentucky, Lexington, Kentucky, USA, discussed the modern use of bedside ultrasonography in the initial evaluation of trauma patients.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EBedside ultrasonography has been shown to be equal to or more sensitive than other modalities for detecting traumatic injuries. In a randomized controlled clinical trial, patients presenting to the emergency department with suspected torso damage assessed with ultrasonography had considerably decreased time to operative care, improved resource use, and lower medical costs [Melniker LA et al. \u003Cem\u003EAnn Emerg Med.\u003C\/em\u003E 2006]. A more recent study reported that bedside ultrasonography had higher sensitivity and similar specificity compared with chest radiography for the diagnosis of pneumothorax [Ding W et al. \u003Cem\u003EChest\u003C\/em\u003E. 2011].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPoint-of-care ultrasonography has long been used for the assessment of hemoperitoneum and hemopericardium in emergency departments and operating rooms [Rippey JC, Royse AG. \u003Cem\u003EBest Pract Res Clin Anaesthesiol\u003C\/em\u003E. 2009]. Ultrasonography can also be used to assess vascular injuries, musculoskeletal injuries, genitourinary injuries, and fetal viability in pregnant trauma patients. In addition, ultrasonography can be used to guide nerve blocks and vascular access in real time.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAnother application that may be useful in the setting of trauma is the tracheal rapid ultrasound examination [Chou HC et al. \u003Cem\u003EResuscitation\u003C\/em\u003E. 2011]. Correct positioning of an endotracheal tube can be confirmed by a sonographer within 3 seconds of placement, with 100% sensitivity and specificity [Muslu B et al. \u003Cem\u003EJ Ultrasound Med.\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAnother useful application of ultrasonography is as a noninvasive test for elevated intracranial pressure (ICP). Optic nerve sheath diameter \u0026gt; 5 mm as detected by ocular ultrasonography identifies patients with ICP \u0026gt; 20 cm H\u003Csub\u003E2\u003C\/sub\u003EO and has been highly correlated with ventriculostomy measurements [Kimberly HH et al. \u003Cem\u003EAcad Emerg Med.\u003C\/em\u003E 2008]. Third-ventricle midline shift as evaluated by transcranial color-coded sonography is more sensitive and specific than the pulsatility index in detecting large intracerebral hemorrhage and it is also a significant predictor of short-term functional outcome (OR, 2.09; 95% CI, 1.06 to 4.13) [Tang SC et al. \u003Cem\u003EJ Ultrasound Med.\u003C\/em\u003E 2006].\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPoint-of-care ultrasonography is particularly useful in settings in which traditional radiography is unavailable or undesired. Clavicle fracture, a common orthopedic injury in children, can be diagnosed with bedside ultrasonography with 95% sensitivity, 96% specificity, and 96% overall accuracy [Cross KP et al. \u003Cem\u003EAcad Emerg Med.\u003C\/em\u003E 2010]. Even in the hands of physicians with minimal training, portable ultrasonography is useful for detecting fractures in a remote setting [Marshburn TH et al. \u003Cem\u003EJ Trauma\u003C\/em\u003E. 2004].\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EUltrasonography has long been the standard for hemodynamically unstable patients with concerning mechanism of injury. However, ultrasonography is also being use to assess and to follow-up on stable patients with blunt abdominal trauma concern for solid organ (liver, spleen, kidneys) damage, particularly in low-energy injuries [Afag A et al. \u003Cem\u003EEur J Emerg Med.\u003C\/em\u003E 2012].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/46\/11.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzogxp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}