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Abdominal Trauma

Date Last Search Run: Jun 11, 2024
Table last updated: Jun 22, 2024
Data last added: Jun 22, 2024

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)    
3 (weak evidence exists)    


Interventions

Direct Pressure
Level Direction Primary Outcome Patient/Process Setting Reference
III Neutral (Yellow) Mortality Patient PH-Paramedic Chaudery M., Clark J., Wilson MH., Bew D., Yang GZ., Darzi A. Traumatic intra-abdominal hemorrhage control: Has current technology tipped the balance toward a role for prehospital intervention? J Trauma Acute Care Surg 2015; 78(1):153-63. Medline

FAST
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) accuracy of prehospital FAST exam Process PH-Paramedic & MD Gamberini L, Scquizzato T, Tartaglione M, et al. Diagnostic accuracy for hemoperitoneum, influence on prehospital times and time-to-definitive treatment of prehospital FAST: A systematic review and individual participant data meta-analysis. Injury March 2023. Medline
II Supportive (Green) Door to CT time Process PH-MD & CCT Gamberini L, Tartaglione M, Giugni A, Alban L, Allegri D, Coniglio C, et al. The role of prehospital ultrasound in reducing time to definitive care in abdominal trauma patients with moderate to severe liver and spleen injuries. Injury 2021. Medline
II Supportive (Green) resolution Process PH-Paramedic Lobo MJCD, Tavares SCCNM, Pereira de Almeida RP. Point of care prehospital ultrasound in Basic Emergency Services in Portugal. Heal Sci Rep 2022; 5(5):e847. Medline
II Supportive (Green) Diagnosis Process PH-Paramedic & MD Lucas B, Hempel D, Otto R, Brenner F, Stier M, Marzi I, et al. Prehospital FAST reduces time to admission and operative treatment: a prospective, randomized, multicenter trial. Eur J Trauma Emerg Surg 2021. Medline
II Supportive (Green) Presence of posttraumatic severe hemorrhage Patient ICU Stralec G, Fontaine C, Arras S, et al. Is a positive prehospital FAST associated with severe bleeding? A multicenter retrospective study. Prehosp Emerg Care October 2023; 1-27. Medline
II Supportive (Green) Frequency of use Process PH-MD & CCT Vianen NJ, Van Lieshout EMM, Vlasveld KHA, Maissan IM, et al. Impact of Point-of-Care Ultrasound on Prehospital Decision Making by HEMS Physicians in Critically Ill and Injured Patients: A Prospective Cohort Study. Prehosp Disaster Med. July 2023; 1-6. Medline
II Supportive (Green) Positive and negative predictive value Patient PH-Paramedic Yates JG, Baylous D. Air Medical Ultrasound: Looking Back to See What We Have Learned for the Future. Air Med J. 2022 Nov-Dec;41(6):536-541. doi: 10.1016/j.amj.2022.08.006. Epub 2022 Oct 26. PMID: 36494169. Medline
III Supportive (Green) Diagnostic Accuracy Process PH-Paramedic Ienghong K, Cheung LW, Tiamkao S, Bhudhisawasdi V, Apiratwarakul K. The Utilization of Handheld Ultrasound Devices in a Prehospital Setting. Prehosp Disaster Med 2022; 37(3):355–9. Medline
III Supportive (Green) Frequency of indications Process PH-Paramedic & CCT Lenz TJ, Phelan MB, Grawey T. Determining a Need for Point-of-Care Ultrasound in Helicopter Emergency Medical Services Transport. Air Med J 2021; 40(3):175–8. Medline
III Supportive (Green) Time elapsed from prehospital FAST to arrival in trauma room Patient PH-Paramedic & MD Lucas B, Hempel D, Otto R, Brenner F, Stier M, Marzi I, et al. Prehospital FAST reduces time to admission and operative treatment: a prospective, randomized, multicenter trial. Eur J Trauma Emerg Surg 2021. Medline
X Not Yet Graded (White) - Lin KT, Lin ZY, Huang CC, et al. Prehospital ultrasound scanning for abdominal free fluid detection in trauma patients: a systematic review and meta-analysis. BMC Emerg Med January 2024; 24(1):7. Medline

Stabilize Impaling Object
Level Direction Primary Outcome Patient/Process Setting Reference


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