Effectiveness of Ultrasound as a Triage Tool in Ruling out Fractures among Non-Critical Emergency Department Patients
- Author:
Nik Muhamad NA
;
Ganesan Murthi j
;
Nik Ismail NA
- Publication Type:Journal Article
- Keywords:
emergency;
fractures;
triage;
ultrasound
- MeSH:
Ultrasonography
- From:Medicine and Health
2015;10(2):103-111
- CountryMalaysia
- Language:English
-
Abstract:
The popularity of ultrasound for acute diagnosis of fractures in the Emergency
Department (ED) has increased over the recent years. This present study aimed to
determine the sensitivity and specificity of ultrasound use for detection of fractures
in a different environment, which is at the triage area of the ED. We compared
the results of bedside ultrasound in detecting non-critical fractures to the current gold standard of X-rays in the triage area. The design was a single centered crosssectional
study. From August 2014 till November 2014, a total of 46 patients were
recruited, creating 75 image pairs. Following consent, a bedside ultrasound was
performed and subsequently compared with X-ray reporting regarding the presence
or absence of fractures. SPSS analysis was used to determine the sensitivity and
specificity of ultrasound in diagnosing fracture as compared to X-rays. Ultrasound
had a sensitivity of 72% (95% CI, 50.6% - 87.9%) and a specificity of 80% (95%CI:
66.3 – 90%) when compared to X-rays in fracture diagnosis. The kappa analyses
showed moderate inter observer agreement (0.5) between ultrasound and X-rays in
diagnosing fractures. This study suggests that the use of ultrasound as a triage tool
yet has unacceptable sensitivity and needs further evaluation and consideration.
- Full text:P020151118520068196000.pdf
