RESUMO
We describe a point-of-care ultrasonography to facilitate diagnosis of a femur fracture in a 13-year-old adolescent boy. Rapid detection of the fracture, which was not possible by physical examination alone, permitted immediate stabilization of the leg with traction, rapid communication with orthopedic surgeons, and facilitated analgesic therapy before transport and movement to obtain radiographs.
Assuntos
Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/terapia , Ultrassonografia/métodos , Adolescente , Gerenciamento Clínico , Diagnóstico Precoce , Feminino , Humanos , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
This research investigated effectiveness of temporal artery thermometry (TAT) to detect high rectal fever in children ≥ 91 days and ≤ 4 years old. Rectal temperature was initially evaluated immediately followed by TAT. As expected, the difference between mean rectal (38.05 ± .99 °C) and mean TA (37.55 ± .8 °C) temperatures in subjects (N = 239) was significant (p < .0001). Linear regression revealed TAT underestimated rectal thermometry with greater frequency at higher temperatures. This observation provides probable explanation for the disparity between these thermometry methods. A TAT sensitivity of 75% and specificity of 85% were determined for detecting high fever (39 °C)-a finding clinically unacceptable. In contrast, among the small number of injured subjects enrolled, TAT detected high rectal fever with 100% sensitivity and specificity. This finding, if confirmed, suggests TAT screening for well and injured children has potential for clinical practice by diminishing rectal measurements and their associated risks in the acute care and/or ambulatory practice setting.