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POCUS-CRAFT: a novel integrated ultrasound trauma protocol

Jakub Czerwiec

Jakub Czerwiec

  • Institute of Medicine, Academy of Applied Sciences in Nowy TargPoland
  • Sądeckie Emergency Medical ServicePoland
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Czerwiec, Jakub
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Dorota Sobczyk

Dorota Sobczyk

  • Department of Cardiovascular Diseases, Medical College, Jagiellonian UniversityPoland
  • Cardiovascular Surgery and Transplantology Department, St John Paul II HospitalPoland
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Sobczyk, Dorota
  
30 giu 2025
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Categoria dell'articolo: Research paper
Pubblicato online: 30 giu 2025
Ricevuto: 06 giu 2025
Accettato: 25 giu 2025
DOI: https://doi.org/10.15557/jou.2025.0018
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© 2025 Jakub Czerwiec et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

POCUS-CRAFT flowchart
POCUS-CRAFT flowchart

Fig. 2.

Temporal acoustic window (A); imaging of the contralateral temporal bone (white arrow), midbrain – butterfly sign (red arrow)(B); measurement of the optic nerve sheath diameter (C). Color Doppler imaging of the middle cerebral artery (D); PW Doppler imaging of MCA low-resistance flow with PI calculation (E)
Temporal acoustic window (A); imaging of the contralateral temporal bone (white arrow), midbrain – butterfly sign (red arrow)(B); measurement of the optic nerve sheath diameter (C). Color Doppler imaging of the middle cerebral artery (D); PW Doppler imaging of MCA low-resistance flow with PI calculation (E)

Fig. 3.

Cardiac views: subcostal 4-chamber (A), parasternal long axis, (B) and parasternal short axis (C)
Cardiac views: subcostal 4-chamber (A), parasternal long axis, (B) and parasternal short axis (C)

POCUS-CRAFT protocol: ultrasound findings and their clinical significance

Letter Explanation Ultrasound findings T (Trauma Integration) Clinical conclusion
C Cranium

MCA PI >1.2

ONSD >5 mm

Unconsciousness

High GCS

High BP

 Possible elevated ICP
R Respiratory Abolished pleural sliding, PLAPS point, barcode sign

Dyspnea

Low BP

High respiratory rate

Tachycardia

Low SpO2

 Pneumothorax
Presence of pleural free fluid Pleural bleeding or effusion
A Abdomen Free peritoneal and/or pelvic fluid

Low BP

Tachycardia

Low SpO2

High NRS

 Peritoneal or pelvic bleeding/effusion
F Cardiac Function

Pericardial effusion

Diastolic collapse of right atrium and right ventricle

Dyspnea

Low BP

Tachycardia

Low SpO2

High NRS

 Cardiac tamponade

Small LV

Hyperdynamic LV function

 Hypovolemia
Depressed LV systolic function

Cardiac contusion

Myocardial infarction

POCUS-CRAFT protocol views

Letter Explanation Ultrasound modality Ultrasound views Parameters
C Cranium

Transcranial Doppler

Transorbital ultrasound

MCA

Optic nerve

Flow spectrum in MCA

ONSD
R Respiratory Lung ultrasound

Upper anterior

PLAPS points

Pneumothorax evidence

Pleural fluid
A Abdomen Abdominal ultrasound

RUQ

LUQ

Pelvic

 Free peritoneal and/or pelvic fluid
F Cardiac Function Echocardiography

PLAX

PSAX

SC4CH

Pericardial tamponade

Hyper/hypodynamic LV function
T Trauma Integration Clinical integration with physical examination N/A HR, BP, RR, SaO2, temperature, GCS, NRS scales
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicina, Scienze medicali di base, Scienze medicali di base, altro
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