Observation period for asymptomatic penetrating chest trauma: 1 or 3 h?
| Autor: | Arezoo Yari, Amirhossein Mirafzal, Mitra Movahedi, Masoud Mayel, L. Seidzadeh Gooklan, S. Nazemi |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Thoracic Injuries Concordance Observation period Wounds Penetrating Computed tomography Iran Critical Care and Intensive Care Medicine Asymptomatic Young Adult 03 medical and health sciences 0302 clinical medicine Clinical Protocols Humans Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Aged medicine.diagnostic_test business.industry Trauma center Pneumothorax 030208 emergency & critical care medicine Emergency department Middle Aged medicine.disease Thoracostomy Patient Discharge Surgery Cross-Sectional Studies Anesthesia Emergency Medicine Female medicine.symptom Emergency Service Hospital Tomography X-Ray Computed business |
| Zdroj: | European Journal of Trauma and Emergency Surgery. 44:829-833 |
| ISSN: | 1863-9941 1863-9933 |
| DOI: | 10.1007/s00068-015-0623-8 |
| Popis: | Current recommendations for evaluation and safe discharge of penetrating chest trauma patients regarding pneumothorax (PTX) include a Chest X Ray (CXR) at the Emergency Department (ED) upon arrival and second CXR after 3 h if the first one is negative. To compare CXRs taken at the first and third hours of ED arrival and evaluate a 1 h period of observation instead of 3 h for safe discharge of patients with penetrating chest trauma. In this cross-sectional study, all asymptomatic patients with penetrating chest trauma referred to a level 1 trauma center with negative initial Postero-Anterior (PA) CXRs (hour 0) were enrolled. Those with intoxication, tube thoracostomy, chest computed tomography, evidence of abdominal penetration, an overall elapsed timed of more than 1 h for admission to the ED, and refusal to take part in the study were excluded. Patients underwent subsequent PA CXRs at hours 1 and 3. A phone call follow up after 24 h was organized for each patient. A total of 68 patients were enrolled. There was 100 % concordance among CXRs performed at hours 1 and 3 in the study population. None of the patients showed clinical deterioration or PTX in CXR at hour 1 if remained asymptomatic during the first hour of observation. Asymptomatic patients with penetrating chest trauma, negative initial PA CXR, no signs of intoxication, and no deterioration during the first hour of observation may be considered for discharge. Further evidence is required to make recommendations based on these findings. |
| Databáze: | OpenAIRE |
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