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Related Experiment Videos

Diagnostic peritoneal lavage analysis: should trauma guidelines be revised?

C Maxwell-Armstrong1, A Brooks, M Field

  • 1Queens Medical Centre, Nottingham, UK. charles.maxwell-armstrong@talk21.com

Emergency Medicine Journal : EMJ
|November 8, 2002
PubMed
Summary

Diagnostic peritoneal lavage (DPL) is rarely performed by UK surgeons and DPL sample analysis is often unavailable, especially outside of standard working hours. Current trauma guidelines should be revised to favor abdominal ultrasound.

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Surgical Diagnostics

Background:

  • Diagnostic peritoneal lavage (DPL) is a procedure used to detect internal bleeding in patients with abdominal trauma.
  • Current Advanced Trauma Life Support (ATLS) guidelines mandate laparotomy based on DPL results.
  • The study aimed to evaluate the practical feasibility of performing and analyzing DPL in UK trauma units.

Purpose of the Study:

  • To assess the practical capability of performing DPL by UK surgeons.
  • To determine the availability of DPL sample analysis by UK haematology departments.
  • To evaluate the current practice and experience of DPL among surgical trainees and consultants.

Main Methods:

  • A telephone survey of haematology technicians in 40 UK major trauma units.

Related Experiment Videos

  • A questionnaire survey of 1797 general surgical trainees and consultants regarding their DPL experience.
  • Surveys were conducted during and outside of standard working hours.

    • Main Results:

    • Only 29 out of 40 (72.5%) haematology technicians could analyze DPL samples during working hours, compared to 9 out of 40 (22.5%) out of hours.
    • Approximately 60% of surveyed surgeons had performed fewer than 10 DPLs in their careers.
    • A 48% response rate was achieved from the surgical trainee and consultant survey.

    Conclusions:

    • UK surgeons possess limited experience in performing DPL.
    • Haematology departments face challenges in analyzing DPL samples, particularly outside of standard hours.
    • The study suggests revising ATLS guidelines to favor abdominal ultrasound over DPL for diagnosing intra-abdominal bleeding.