Ultrasonography for the evaluation of abdominal trauma in multiple casualty incidents

Objective: Ultrasound (US) is commonly used for the diagnosis of hemoperitoneum in trauma patients. The use of US in the evaluation of abdominal injury during multiple casualty incidents (MCIs) has been described, but never evaluated. The purpose of this study was to determine the accuracy of US for evaluation of the unique injury patterns associated with MICs. Patients and methods: We conducted a retrospective study of patients admitted to a Level 1 trauma center during MCIs resulting from terrorist attacks in the Tel-Aviv area. Results: During the 4-year study period there were 43 patients who had an US examination as part of their initial assessment. The overall accuracy of the US examination was 77%, with a sensitivity of 40%, and a specificity of 88%. The positive predictive value (PPV) was 50%, and the negative predictive value (NPV) was 83%. Conclusions: Although US examination lacks the sensitivity to be used alone in determining operative intervention in the evaluation of patients admitted in an MCI, a reasonable specificity might justify its use as a screening tool in MCIs.