The Role of Prehospital eFAST in Accelerating Time to Diagnostics or Definitive Treatment in the Emergency Department

Completed

• Conditions: Trauma Abdomen; Trauma Splenic; Liver Injury
• Interventions: Diagnostic Test: prehospital extended focused assessment sonography for trauma

• Registration Number: NCT04934384
• Lead Sponsor: Azienda Usl di Bologna

Brief Summary

Actual literature has demonstrated that prehospital extended focused assessment sonography for trauma (eFAST) could impact on logistic and treatment decisions such as mode of transportation and choice of hospital destination.

However, there are no data with regard to in-hospital effects of a positive prehospital eFAST.

The main objective of this study was to evaluate the effects of prehospital eFAST driven decisions on in hospital time-to-definitive diagnostics or time-to definitive treatment, whichever came first, in a level 1 trauma center.

The goal is to define if this information could have a role in prioritizing patients' access to care in a population of abdominal trauma patients with A-AIS \> 1 and a documented liver or spleen injury.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-06-14
• Study First Submitted QC: 2021-06-21
• Study First Posted: 2021-06-22
• Study Start: 2021-06-25
• Status Verified: 2021-07
• Primary Completion: 2021-07-15
• Study Completion: 2021-07-26
• Last Update Submitted: 2021-07-29
• Last Update Posted: 2021-08-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 199

Inclusion Criteria

• Patients admitted to emergency department with a ICD-9-CM diagnosis of traumatic liver or spleen injury (codes 8640x, 8641x, 8650x, 8651x)
• Abdominal AIS ≥ 2
• CT scan or operating theatre admission performed within 180 minutes from ED admission

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Exclusion Criteria

• Death before CT scan or OR/Angio suite admission (missing primary outcome measure)
• Transferred to other hospitals before CT scan or operating room admission
• Missing data

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Negative or not performed prehospital eFAST	prehospital extended focused assessment sonography for trauma	Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs
Positive prehospital eFAST	prehospital extended focused assessment sonography for trauma	Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs

Primary Outcome Measures

Name	Time	Method
Time to definitive diagnostics or treatment	180 minutes	Time from the ED arrival to CT scan imaging or surgical intervention (whichever came first)

Secondary Outcome Measures

Name	Time	Method
Sensitivity and specificity of prehospital eFAST	240 minutes	Sensitivity and specificity of prehospital eFAST calculated considering ED eFAST as the gold standard measure
Prehospital time	240 minutes	Time from EMS dispatch to ED arrival

Trial Locations

Locations (1)

Maggiore Hospital Ospedale Maggiore Carlo Alberto Pizzardi AUSL di Bologna; 🇮🇹 Bologna, Italy