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

• Published in: Prehospital and disaster medicine 2024-04, Vol.39 (2), p.206-211
• Main Authors: Cetinkaya, Remzi, Ozel, Mehmet, Tatliparmak, Ali Cankut, Yılmaz, Sarper, Ak, Rohat
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Child; Child, Preschool; Computed Tomography Angiography; Crush Injuries - diagnostic imaging; Dialysis; Earthquakes; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Exigent circumstances; Fatalities; Female; Fractures; Health sciences; Hemodialysis; Hospitals; Humans; Injuries; Male; Medical diagnosis; Medical imaging; Middle Aged; Patients; Provinces; Research Report; Retrospective Studies; Seismic activity; Surgeons; Tomography; Ultrasonic imaging; Ultrasonography, Doppler; Veins & arteries; Young Adult
• ISSN: 1049-023X; 1945-1938; 1945-1938
• DOI: 10.1017/S1049023X24000086

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). 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. 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). 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.