Prospective Evaluation of Safe Observation Period after Asymptomatic Penetrating Thoracic Injury: 1 Hour is Enough

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HEYDARI FARHAD; MASOUMI BABAK; ZAMANI MAJID; Nasr Esfahani Mohammad

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Journal: Frontiers in Emergency Medicine Year:2019 | Volume:3 | Issue:4 Page(s): 0-0

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Title

Prospective Evaluation of Safe Observation Period after Asymptomatic Penetrating Thoracic Injury: 1 Hour is Enough

Author(s)

HEYDARI FARHAD | MASOUMI BABAK | ZAMANI MAJID | Nasr Esfahani Mohammad | Issue Writer Certificate

Keywords

Delayed Pneumothorax

Hemothorax

Penetrating

Pneumothorax

Thoracic Injury

Abstract

Introduction: The observation period was recently challenged by some studies; and it has been suggested that a 1-hour observation period may be sufficient to allow safe discharge in asymptomatic patients with Penetrating Thoracic Injury (PTI) and normal initial Chest X-Ray (CXR). Objective: The current study was performed to investigate if in asymptomatic and hemodynamically stable patients with PTIs who has an initial normal evaluation, 1-hour observation interval is safe to detect clinically significant injuries and is it possible to discharge these patients safely after a negative Extended – Focused Assessment with Sonography in Trauma (E-FAST) at hour1 instead of hour 3. Method: This cross-sectional study was performed on asymptomatic patients with Penetrating Thoracic Injury, referred to emergency department (ED) and normal initial CXR and the Extended Focused Assessment with Sonography in Trauma (E-FAST). The second E-FAST was done 1 hour after the first one and the third repeat E-FAST and control CXR then performed 3 hours post-injury. 24 hours follow up by phone call was done for each patient after discharge. Results: Finally, 117 patients with the average ages of 25. 9 ± 7. 8 years were enrolled of whom 92. 5% were male. Eight patients developed PTX or HTX during first hour of observation that were diagnosed by E-FAST or CT scan requested by the in-charge physician. One hundred-nine patient completed E-FAST and radiograph studies at times zero, 1 h, and 3 h. One patient had a normal initial evaluation but demonstrated a PTX on the 3-h managed without intervention. The rate of delayed abnormality after an initially normal study was 7. 7 % (9/117). No discharged patients returned to our ED with delayed manifestations of either PTX or HTX. Conclusion: The results of our study have shown that asymptomatic patients with PTI with negative initial evaluation and no deterioration at intervals, about 1 hour may be sufficient for detection of clinically significant pathology, considered for safe and early discharge.

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APA: Copy

HEYDARI, FARHAD, MASOUMI, BABAK, ZAMANI, MAJID, & Nasr Esfahani, Mohammad. (2019). Prospective Evaluation of Safe Observation Period after Asymptomatic Penetrating Thoracic Injury: 1 Hour is Enough. (FRONTIERS IN EMERGENCY MEDICINE) ADVANCED JOURNAL OF EMERGENCY MEDICINE, 3(4), 0-0. SID. https://sid.ir/paper/351104/en

Vancouver: Copy

HEYDARI FARHAD, MASOUMI BABAK, ZAMANI MAJID, Nasr Esfahani Mohammad. Prospective Evaluation of Safe Observation Period after Asymptomatic Penetrating Thoracic Injury: 1 Hour is Enough. (FRONTIERS IN EMERGENCY MEDICINE) ADVANCED JOURNAL OF EMERGENCY MEDICINE[Internet]. 2019;3(4):0-0. Available from: https://sid.ir/paper/351104/en

IEEE: Copy

FARHAD HEYDARI, BABAK MASOUMI, MAJID ZAMANI, and Mohammad Nasr Esfahani, “Prospective Evaluation of Safe Observation Period after Asymptomatic Penetrating Thoracic Injury: 1 Hour is Enough,” (FRONTIERS IN EMERGENCY MEDICINE) ADVANCED JOURNAL OF EMERGENCY MEDICINE, vol. 3, no. 4, pp. 0–0, 2019, [Online]. Available: https://sid.ir/paper/351104/en

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