The incidence of pericardial effusions as it relates to cardiac disease, rheumatologic disease, and post-operatively is well documented. In the 7 months the Adult Trauma Center has been open at University of Chicago, there have been a surprising number of incidental pericardial effusions found on bedside ultrasound during trauma activations in the Emergency Department (ED). This can be problematic for trauma management in the ED, as prompt diagnosis of traumatic pericardial effusions is paramount, and uncertainty to this end can lead to unnecessary operative procedures. With the advances in ultrasound technology in recent years, small pericardial effusions are now being detected with astounding accuracy, leading to cognitive delay in evaluation of trauma patients. We propose an analysis of patients 18-65 years of age with pericardial effusions found on Focused Assessment with Sonography in Trauma (FAST) Exams to determine the prevalence clinically significant pericardial effusions as a result of blunt or penetrating thoracic trauma.. This investigation could lead to practice-changing methodologies, as patients who are victims of blunt or penetrating trauma receive certain highly-invasive operations and procedures based on immediate evaluation with bedside ultrasound, while the prevalence of incidental pericardial effusions is not well documented. Patients may inappropriately be receiving these highly invasive procedures for serous effusions, rather than the presumed hemorrhagic (traumatic) pericardial effusions they are reserved for in our practice. This study would serve as a foundation to further research and possible changes to Trauma methodologies.

I) Perform a literature review on incidence of pericardial effusions in patients age 18-65, the disease state or surgeries most commonly associated, and prevalence of clinically significant pericardial effusions in trauma patients

II) Develop an Institutional Review Board (IRB) submission for retrospective review of all bedside FAST exams for evaluation of pericardial effusions and their characteristics

III) Review collated ultrasound studies for positive studies evaluating pericardial effusion and document MRNs, demographic information, formal ECHO and diagnostic procedures performed and discharge diagnosis

IV) Data Analysis on patients with pericardial effusion, their ultrasounds and hospital course

V) Write an Abstract and Manuscript for National or Regional Presentation and high impact-factor journal submission.

VI) Fulfill all SRP requirements including oral presentation and manuscript development in a timely fashion

Students involved in this project will be part of a team of ED clinicians working to investigate pericardial effusions diagnosed by beside ultrasound in the ED, determining chronicity, etiology and mortality based on chart analysis and develop an abstract and manuscript for publication & presentation. Students will work with residents and attending physicians to first review all ultrasound images and documented findings, categorize positive studies and evaluate their workup, past medical history, diagnoses and mortality. The student will work to develop an IRB for approval, become proficient in data collection and analysis, and work with the research mentor on developing an oral presentation and manuscript. We will also work to submit both of these to local/national conferences and high-impact factor journals for publication.

EPIC Access

Microsoft Excel

Microsoft Word

Weekly Ultrasound Lectures with Dr. Hafez