Pneumothorax Clinical Trial
Official title:
Comparison Of Chest Ultrasound Techniques To Identify Clinically Significant Pneumothorax
Patients with chest trauma undergo ultrasound to detect a collapsed lung. Two techniques have been described. A single view for each hemi-thorax, and multiple views for each hemithorax. The investigators are comparing these two techniques in a randomized prospective trial.
This is a randomized, prospective blinded study on trauma patients arriving to an emergency
department.
Study Setting and Population This study will be conducted on the University Campus of the
University of Massachusetts Medical Center, which is an urban academic emergency department
that sees 80,000 patients annually and has a dedicated Level I trauma service that is
staffed by trauma surgery and emergency medicine. Adult patients with acute traumatic injury
who are undergoing a CT scan of the chest are eligible for enrollment.
Study Protocol Trauma patients are enrolled as they arrived to the emergency department. The
investigators will include any trauma patient aged 18 and over. The investigtors will
exclude any patient who was too unstable and required clinical care that prevented
performing a chest wall ultrasound, patients with a chest tube in place prior to arrival,
pregnant women, and prisoners. Imaging decisions on trauma patients will be made early on in
their evaluation. The patient will be assigned using a pre-determined randomization scheme
to a single view or four views of each hemi-thorax prior to any imaging being done.
Ultrasounds will be performed and interpreted by credentialed physicians using a 7.5Mhz
linear array transducer on a portable ultrasound machine (Zonare z.one ultra) with digital
clips recorded for later review. When the investigators obtain a single view of each
hemi-thorax, the probe will be placed in a longitudinal orientation on the midclavicular
line in the third intercostal space. When teh investigators obtain four views of each
hemi-thorax, the first image location will be the same as in the single view and then the
probe will be moved inferiorly and laterally to obtain the additional three images.
Immediately following the ultrasound examination, the patient will be transported to the CT
scanner for further imaging.
The goal of this study is to determine if a single view of each hemi-thorax can identify a
pneumothorax or if additional images should be included. The primary study endpoint is the
presence of a pneumothorax on ultrasound.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Diagnostic
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