Is the SILENT test a feasible alternative to routine clinical trauma bay assessment of injuries to the lower limb? – A survey of clinical practicing level I trauma surgeons

Purpose:

In a trauma bay setting, patients are examined according to standardized protocols. However, there is no standardized technique described in the literature today, detailing fracture detection. The aim of this study was to conduct a follow-up study on the SILENT test in order to construct a specialist assessment.

Methods:

Medical professionals (MD) of a level 1 trauma center were enquired to complete a survey with 32 questions, designed to evaluate a novel clinical fracture detection test, the SILENT test. Feasibility, safety, certainty, duration and general questions were asked and compared with individual techniques of examining the lower extremities during Primary Survey in a trauma bay setting.

Results:

This study included 56 MD participants, with the majority being ATLS providers (n = 46, 82.1%) and ten participants were ATLS instructors (17.9%). 57.1% of the participants supervises more than 100 trauma bay patients at the time of the study. Most participants reported the SILENT to be more standardized when compared to the routine examination (n = 44, 78.6%) and most participants declared the SILENT to be much more reproducible when compared to their routine examination (n = n = 44, 78.6%).

Conclusion:

The majority of medical professionals consider the SILENT test easier, faster, safer, and more standardized to perform, compared to their habitual examination method and would recommend the test to be a permanent part of the primary survey. Further surveys and tests should be performed to evaluate the SILENT test outside of the trauma bay (e.g. emergency department or in the preclinical phase). A negative SILENT test might reduce the requirement of additional radiological imaging. A positive SILENT test can alert the whole OR team to prepared for a upcoming emergency surgeries.

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