Date of Award
Open Access Dissertation
College of Nursing
Embedded soft tissue foreign bodies are common complaints of patients presenting to rural urgent care centers. The removal of soft tissue foreign bodies present challenges for the healthcare provider when objects are radiolucent and cannot be identified on readily available diagnostic imaging modalities such as plain radiographs (X-rays). Ultrasound has been introduced in the literature as a useful adjunct to X-rays for the localization and removal of soft tissue foreign bodies. The purpose of this research utilization project was to report the use of bedside ultrasound by healthcare providers as an adjunct to X-ray for the localization and removal of foreign bodies in soft tissue wounds among patients presenting to an urgent care setting. A total of 45 patients' medical records were selected for this retrospective chart review. Patients' ages ranged from two to 88 years with a mean age of 39 years. The selected patients in the chart review underwent soft tissue foreign body removal with the use of X-ray alone (N=24), ultrasound and X-ray (N=8), and without the use of X-ray or ultrasound (N=13). Medical records of the three groups of patients were compared for the following variables: time from the onset of the foreign body removal procedure to patient discharge; the location of the foreign body and time of removal to discharge; and types of foreign body material and time for removal to discharge. X-ray alone detected 10 of 24 soft tissue foreign bodies with a removal time to patient discharge of 22 minutes. X-ray and ultrasound in parallel detected all 8 soft tissue foreign bodies with a removal time to patient discharge of 19 minutes. Without diagnostic imaging 13 soft tissue foreign bodies were detected with blind probing by the provider with a removal time to patient discharge of 16 minutes. Pertinent comparisons also yielded pain as the most common presenting symptom associated with an embedded soft tissue foreign body while the finger was the most commonly affected anatomical location. Wooden foreign body material required the greatest extraction time compared to metal and glass. In this research utilization project, the implementation of ultrasound as an adjunct to X-ray for the localization and removal of soft tissue foreign bodies had favorable outcomes when used to remove both radiolucent and radiopaque objects compared to X-ray alone in the urgent care setting.
Merritt, S. L.(2013). The Use of Ultrasound as an Adjunct to X-Ray For the Localization and Removal of Soft Tissue Foreign Bodies in an Urgent Care Setting. (Doctoral dissertation). Retrieved from http://scholarcommons.sc.edu/etd/2486