The effectiveness of the protocol of focused ultrasound examination of the wounded and injured in combat surgical trauma

Abstract

The provision of medical care in armed conflicts has several features. Ultrasound examination is one of the available and informative diagnostic methods for the wounded and injured under conditions of limited material and technical resources. The sensitivity and specificity of the diagnosis of free fluid in the abdominal cavity and pneumothorax using an extended protocol of focused ultrasound evaluation in wounded patients with combat trauma requiring surgical care were determined. A retrospective cohort study of the medical data of 85 patients with injury and chest and abdominal wounds was performed to identify the extent of damage. For this purpose, a focused ultrasound examination was performed using an extended protocol of focused ultrasound evaluation in patients with wounds and combat trauma. This protocol was applied to all victims with chest and abdominal wounds to identify the extent of damage. The results revealed that the sensitivity and specificity of the extended protocol of focused ultrasound evaluation in the wounded during combat trauma for the diagnosis of free fluid in the abdominal cavity were 100% and 66%, respectively. The sensitivity and specificity of the extended focused ultrasound evaluation protocol for the diagnosis of pneumothorax in the wounded during combat trauma were 87% and 78%, respectively. The results further confirmed the need to use an expanded protocol of focused ultrasound assessment in wounded patients with combat trauma to make decisions on the surgical techniques in settings where other diagnostic methods were not unavailable, particularly during armed conflicts with mass admission of wounded and injured patients. In addition, the use by anesthesiologists or surgeons of an extended focused ultrasound evaluation protocol for wounded patients in combat trauma is important, although teamwork is required when deciding about performing surgery.

Keywords

combat injury / bleeding / acute massive blood loss / medical service / special military operation / explosive trauma / bedside ultrasound examination of the lungs / pneumothorax / hemothorax / ultrasound examination

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