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Comparing Doppler Ultrasonography and Computerized Tomography Angiography in Emergency Department Evaluation of Earthquake-Related Crush Injuries: A Case Series Analysis

Published online by Cambridge University Press:  26 February 2024

Remzi Cetinkaya Open the ORCID record for Remzi Cetinkaya [Opens in a new window] ,
Mehmet Ozel Open the ORCID record for Mehmet Ozel [Opens in a new window] ,
Ali Cankut Tatliparmak Open the ORCID record for Ali Cankut Tatliparmak [Opens in a new window] ,
Sarper Yılmaz Open the ORCID record for Sarper Yılmaz [Opens in a new window]  and
Rohat Ak Open the ORCID record for Rohat Ak [Opens in a new window]
Remzi Cetinkaya
Affiliation:
University of Health Sciences, Dept. of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
Mehmet Ozel
Affiliation:
University of Health Sciences, Dept. of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
Ali Cankut Tatliparmak
Affiliation:
Uskudar University Faculty of Medicine, Dept. of Emergency Medicine, Istanbul, Turkey
Sarper Yılmaz*
Affiliation:
University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey The Secretary of the Disaster Commission of the Turkish Emergency Medicine Association, Ankara, Turkey
Rohat Ak
Affiliation:
University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
*
Correspondence: Sarper Yılmaz, MD Department of Emergency Medicine University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital Kartal, Istanbul, Turkey E-mail: sarperyilmaz08@gmail.com
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Abstract

Objective:

This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).

Methods:

This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.

Results:

A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).

Conclusion:

Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.

Keywords

computerized tomography angiographycrush injurydiagnostic imagingdoppler ultrasonographyearthquakeemergency departmentvascular injury
Type
Research Report
Information
Prehospital and Disaster Medicine , Volume 39 , Issue 2 , April 2024 , pp. 206 - 211
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine

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