Antoine Fasseaux1, Philippe Pès2, Françoise Steenebruggen3, Florence Dupriez3. 1. Department of Emergency Medicine, CHR Jolimont, 7100, La Louvière, Belgium. afasseaux@gmail.com. 2. Department of Emergency Medicine, CHU Nantes, Nantes University Hospital, 44000, Nantes, France. 3. Department of Emergency Medicine, Cliniques Universitaires Saint Luc, 1200, Brussels, Belgium.
Abstract
BACKGROUND: Trauma is a major cause of death among the working population. Many countries have now adopted a structured approach to trauma management in which ultrasound is used as a primary evaluation tool. While its use has direct therapeutic benefits, many artifacts and pitfalls are inherent to the technique. Knowledge of the most frequently encountered pitfalls in practice could thus help reduce the risk of error and lead to more accurate trauma assessments. OBJECTIVE: This study evaluates a potential pitfall caused by seminal vesicles during focused assessment with sonography for trauma examinations of the male pelvis performed by an emergency physician with experience in point-of-care ultrasound. METHODS: We took five static and five dynamic (3-s loops) transverse ultrasound images of the pelvis in five healthy males. The images and videos were then incorporated into an online survey and emailed through the World Interactive Network Focused On Critical UltraSound (WINFOCUS) in France and the Ultrasound and Emergency Medicine (UEM) Organization in Belgium. A questionnaire asked anonymous participants to assess the presence of free fluid in the static and dynamic images and to share information about their training and experience in point-of-care ultrasound. To validate the static and dynamic images, the survey was sent to three external radiologists for independent verification. RESULTS: A total of 191 individuals responded fully or partially to the survey, 114 of whom completed it. Among the 114 participants who completed the survey, the misinterpretation rate was 0.55 (95CI 0.51-0.60) for all static and dynamic ultrasound transverse pelvic views. The misinterpretation rate was 0.61 (95CI 0.55-0.66) and 0.50 (95CI 0.45-0.55) for static and dynamic ultrasound transverse pelvic views, respectively. The three external radiologists answered the questionnaire correctly without misinterpreting the survey ultrasound views. CONCLUSIONS: Seminal vesicles are a potential pitfall when interpreting transverse ultrasound images of the male pelvis in the context of point-of-care ultrasound.
BACKGROUND:Trauma is a major cause of death among the working population. Many countries have now adopted a structured approach to trauma management in which ultrasound is used as a primary evaluation tool. While its use has direct therapeutic benefits, many artifacts and pitfalls are inherent to the technique. Knowledge of the most frequently encountered pitfalls in practice could thus help reduce the risk of error and lead to more accurate trauma assessments. OBJECTIVE: This study evaluates a potential pitfall caused by seminal vesicles during focused assessment with sonography for trauma examinations of the male pelvis performed by an emergency physician with experience in point-of-care ultrasound. METHODS: We took five static and five dynamic (3-s loops) transverse ultrasound images of the pelvis in five healthy males. The images and videos were then incorporated into an online survey and emailed through the World Interactive Network Focused On Critical UltraSound (WINFOCUS) in France and the Ultrasound and Emergency Medicine (UEM) Organization in Belgium. A questionnaire asked anonymous participants to assess the presence of free fluid in the static and dynamic images and to share information about their training and experience in point-of-care ultrasound. To validate the static and dynamic images, the survey was sent to three external radiologists for independent verification. RESULTS: A total of 191 individuals responded fully or partially to the survey, 114 of whom completed it. Among the 114 participants who completed the survey, the misinterpretation rate was 0.55 (95CI 0.51-0.60) for all static and dynamic ultrasound transverse pelvic views. The misinterpretation rate was 0.61 (95CI 0.55-0.66) and 0.50 (95CI 0.45-0.55) for static and dynamic ultrasound transverse pelvic views, respectively. The three external radiologists answered the questionnaire correctly without misinterpreting the survey ultrasound views. CONCLUSIONS: Seminal vesicles are a potential pitfall when interpreting transverse ultrasound images of the male pelvis in the context of point-of-care ultrasound.
Authors: Rosemary A Kozar; Frederick A Moore; Ernest E Moore; Michael West; Christine S Cocanour; James Davis; Walter L Biffl; Robert C McIntyre Journal: J Trauma Date: 2009-12
Authors: Dirk Stengel; Johannes Leisterer; Paula Ferrada; Axel Ekkernkamp; Sven Mutze; Alexander Hoenning Journal: Cochrane Database Syst Rev Date: 2018-12-12
Authors: Aaron E Kornblith; Newton Addo; Monica Plasencia; Ashkon Shaahinfar; Margaret Lin-Martore; Naina Sabbineni; Delia Gold; Lily Bellman; Ron Berant; Kelly R Bergmann; Timothy E Brenkert; Aaron Chen; Erika Constantine; J Kate Deanehan; Almaz Dessie; Marsha Elkhunovich; Jason Fischer; Cynthia A Gravel; Sig Kharasch; Charisse W Kwan; Samuel H F Lam; Jeffrey T Neal; Kathyrn H Pade; Rachel Rempell; Allan E Shefrin; Adam Sivitz; Peter J Snelling; Mark O Tessaro; William White Journal: JAMA Netw Open Date: 2022-03-01