The effectiveness of the protocol of focused ultrasound examination of the wounded and injured in combat surgical trauma

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Abstract

The provision of medical care in armed conflicts has several features. Ultrasound examination is one of the available and informative diagnostic methods for the wounded and injured under conditions of limited material and technical resources. The sensitivity and specificity of the diagnosis of free fluid in the abdominal cavity and pneumothorax using an extended protocol of focused ultrasound evaluation in wounded patients with combat trauma requiring surgical care were determined. A retrospective cohort study of the medical data of 85 patients with injury and chest and abdominal wounds was performed to identify the extent of damage. For this purpose, a focused ultrasound examination was performed using an extended protocol of focused ultrasound evaluation in patients with wounds and combat trauma. This protocol was applied to all victims with chest and abdominal wounds to identify the extent of damage. The results revealed that the sensitivity and specificity of the extended protocol of focused ultrasound evaluation in the wounded during combat trauma for the diagnosis of free fluid in the abdominal cavity were 100% and 66%, respectively. The sensitivity and specificity of the extended focused ultrasound evaluation protocol for the diagnosis of pneumothorax in the wounded during combat trauma were 87% and 78%, respectively. The results further confirmed the need to use an expanded protocol of focused ultrasound assessment in wounded patients with combat trauma to make decisions on the surgical techniques in settings where other diagnostic methods were not unavailable, particularly during armed conflicts with mass admission of wounded and injured patients. In addition, the use by anesthesiologists or surgeons of an extended focused ultrasound evaluation protocol for wounded patients in combat trauma is important, although teamwork is required when deciding about performing surgery.

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About the authors

Roman E. Lakhin

Kirov Military Medical Academy

Email: doctor-lahin@yandex.ru
ORCID iD: 0000-0001-6819-9691
SPIN-code: 7261-9985

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Alexander S. Kusai

Kirov Military Medical Academy

Email: doctorcygankov@mail.ru
ORCID iD: 0000-0002-0668-9676
SPIN-code: 8843-5840

Head of Department

Russian Federation, Saint Petersburg

Evgeniy A. Usoltsev

442nd Military Clinical Hospital

Email: doctorcygankov@mail.ru
ORCID iD: 0000-0001-6497-1429
SPIN-code: 3460-8662

anesthesiologist-resuscitator

Russian Federation, Saint Petersburg

Rustam R. Kasimov

Kirov Military Medical Academy; 442nd Military Clinical Hospital

Email: rusdoc77@mail.ru
ORCID iD: 0000-0001-5866-8378
SPIN-code: 5682-2810

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg; Saint Petersburg

Kirill A. Tsygankov

Kirov Military Medical Academy

Author for correspondence.
Email: doctorcygankov@mail.ru
ORCID iD: 0000-0002-2357-0685
SPIN-code: 7133-0503

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vasiliy G. Tsvetkov

Kirov Military Medical Academy

Email: vasilii_cvetkov@mail.ru
ORCID iD: 0000-0003-4980-597X
SPIN-code: 5316-4617
Scopus Author ID: 1119527

senior resident

Russian Federation, Saint Petersburg

Vyacheslav V. Shustrov

Kirov Military Medical Academy

Email: shustrov@anesthvmeda.ru
ORCID iD: 0000-0001-5144-3360
SPIN-code: 5955-7492

lecturer of the Department

Russian Federation, Saint Petersburg

Sergey V. Fadeev

1586nd Military Clinical Hospital (branch No. 3)

Email: doctorcygankov@mail.ru
ORCID iD: 0009-0002-6122-4772
SPIN-code: 1043-7366

Head of the surgical Department

Russian Federation, Naro-Fominsk

References

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Supplementary files

Supplementary Files
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2. Fig. 1. Indicators of the prognostic model of the EFAST protocol for the diagnosis of free fluid in the abdominal cavity

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3. Fig. 2. Indicators of the FAST protocol predictive model for the diagnosis of pneumothorax

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