Utility of Point-of-Care Ultrasonography in Diagnosing Submassive Pulmonary Thromboembolism in a Trauma Patient and Subsequent Anesthetic Management: Case Report and Literature Review

Point-of-care ultrasonography is defined as ultrasonography brought to the patient's bedside and performed by the provider in real time. The clinician can use these real-time dynamic images immediately (rather than images recorded by a sonographer and interpreted later), allowing findings to be directly correlated with the patient's presenting signs and symptoms. Point-of-care ultrasonography is easily repeatable if the patient's condition changes. Over the past decade, the use of point-of-care ultrasonography has extended to emergency settings and intensive care units. The role of ultrasound in triage patients is not only limited to the Focused Assessment with Sonography for Trauma which includes assessment for hemoperitoneum and hemopericardium, it has also been used to detect the presence of hemothorax, pneumothorax, and intravascular filling status in a trauma patient. However, the use of ultrasonography in detecting pulmonary thromboembolism in trauma has not been commonly reported. We report a patient in whom submassive pulmonary embolism was detected by lung ultrasound and thereafter operated for bilateral open Grade III lower-limb fractures. The surgery was proceeded under bilateral ultrasound-guided femoral sciatic nerve block.