Typically, the initial evaluation of blunt trauma patients involves a supine anteroposterior (AP) chest x-ray (CXR) which has a poor sensitivity for the detection of pneumothorax (PTX), and has been reported as low as 20% – 48%. Following the CXR computed tomography (CT) has been the standard for the diagnosis of pneumothorax. The use of ultrasonography to diagnose pneumothorax was first described in 1986 in animal studies. Since then there have been many studies that have shown bedside ultrasound can rapidly detect pneumothorax, helping avoid serious potential consequences (i.e. tension pneumothorax), especially in patients requiring mechanical ventilation. There are several different sonographic signs that can be used to detect pneumothorax, specifically, sonographic lung sliding. But how good is ultrasound for the detection of pneumothorax?
Author Archive for: acirilli
Abnormal vital signs are poor predictors of mortality associated with pulmonary embolism (PE). Diagnosis of PE and right ventricular (RV) strain with transthoracic echocardiography (TTE) however, has been well documented as a predictor for pending shock and significant in-hospital mortality. One study done by Grifoni S et al, showed that 10% of normotensive patients with PE and RV strain on echo developed PE related shock, and 3% died, whereas normotensive patients without signs of RV strain remained hemodynamically stable.
Read more →