POCUS-CRAFT: a novel integrated ultrasound trauma protocol.

Abstract

Aim: The purpose of the study was to create an ultrasound protocol dedicated to patients with multiorgan trauma.

Material and methods: The authors aimed to develop an ultrasound protocol dedicated to patients with multiorgan trauma based on the following: Advanced Trauma Life Support management (ABCDE protocol), available ultrasound protocols for trauma patients, known point-of-care cardiac protocols, and the authors' experience. The indications for the test and the technical requirements necessary for its proper execution are also specified, and the technique of performing the CRAFT test is described.

Results: POCUS-CRAFT represents five components of trauma patient evaluation. C (Cranium): Transcranial Doppler or transorbital ultrasound to assess for elevated intracranial pressure; R (Respiratory): Evaluation of the chest for pneumothorax and pleural hematoma; A (Abdomen): Evaluation of the peritoneal and pelvic cavity for free fluid; F (Cardiac Function): Diagnosis of pericardial tamponade and assessment of left ventricular systolic function; T (Trauma Integration): Integration of ultrasound findings with a complete physical examination of the trauma patient, with emphasis on the clinical context.

Conclusions: POCUS CRAFT is an integrated ultrasound protocol designed for trauma patients. It expands upon the eFAST protocol by adding components for neurological and functional myocardial evaluation. Currently, CRAFT is the only point-of-care protocol that incorporates trauma-related sequelae that can be detected by ultrasound while highlighting the importance of clinical context.