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

Study Overview
=================
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.

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

Conditions
-----------------
Trauma Splenic, Trauma Abdomen, Liver Injury

Intervention / Treatment
-----------------
* Diagnostic Test: prehospital extended focused assessment sonography for trauma


Participation Criteria
=================
Eligibility Criteria
-----------------
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 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

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Positive prehospital eFAST<br>Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs | Diagnostic Test: prehospital extended focused assessment sonography for trauma<br>* Sonographic procedure performed in the prehospital environment aiming at evaluating peritoneal free fluid in trauma patients<br>* Other names: eFAST;|
| Negative or not performed prehospital eFAST<br>Patients with a positive prehospital eFAST, independently from their hemodynamic status or other vital signs | Diagnostic Test: prehospital extended focused assessment sonography for trauma<br>* Sonographic procedure performed in the prehospital environment aiming at evaluating peritoneal free fluid in trauma patients<br>* Other names: eFAST;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to definitive diagnostics or treatment | Time from the ED arrival to CT scan imaging or surgical intervention (whichever came first) | 180 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prehospital time | Time from EMS dispatch to ED arrival | 240 minutes | 
| Sensitivity and specificity of prehospital eFAST | Sensitivity and specificity of prehospital eFAST calculated considering ED eFAST as the gold standard measure | 240 minutes | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
trauma, liver, spleen