Annals of Emergency Medicine
Volume 53, Issue 2 , Pages 208-212 , February 2009

Should the Digital Rectal Examination Be a Part of the Trauma Secondary Survey?

  • Abigail D. Hankin, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Abigail D. Hankin, MD, MPH, Department of Emergency Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; 215-605-7645, fax 215-662-3953
    • ,
  • Jill M. Baren, MD, MBE

References 

  1. Chan S. Forced rectal exam stirs ethical questions. New York Times; January 16, 2008;http://cityroom.blogs.nytimes.com/2008/01/16/forced-rectal-exam-stirs-ethics-questions/Accessed October 31, 2008
  2. Porter JM, Ursic CM. Digital rectal examination for trauma: does every patient need one?. Am Surg. 2001;67:438–441
  3. Esposito TJ, Ingraham A, Luchette FA, et al. Reasons to omit digital rectal exam in trauma patients: no fingers, no rectum, no useful additional information. J Trauma. 2005;59:1314–1319
  4. Guldner G, Babbitt J, Boulton M, et al. Deferral of the rectal examination in blunt trauma patients: a clinical decision rule. Acad Emerg Med. 2004;11:635–641
  5. Guldner GT, Brzenski AB. The sensitivity and specificity of the digital rectal examination for detecting spinal cord injury in adult patients with blunt trauma. Am J Emerg Med. 2006;24:113–117
  6. Kristinsson G, Wall SP, Crain EF. The digital rectal examination in pediatric trauma: a pilot study. J Emerg Med. 2007;32:59–62
  7. Shlamovitz GZ, Mower WR, Bergman J, et al. Lack of evidence to support routine digital rectal examination in pediatric trauma patients. Pediatr Emerg Care. 2007;23:537–543
  8. Shlamovitz GZ, Mower WR, Bergman J, et al. Poor test characteristics for the digital rectal examination in trauma patients. Ann Emerg Med. 2007;50:25–32

 From the Editor—Emergency physicians must often make decisions about patient management without clear-cut data of sufficient quality to support clinical guidelines or evidence-based reviews. Topics in the Best Available Evidence section must be relevant to emergency physicians, are formally peer reviewed, and must have a sufficient literature base to draw a reasonable conclusion but not such a large literature base that a traditional “evidence-based” review, meta-analysis, or systematic review can be performed.

 Supervising editor: Judd E. Hollander, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Reprints not available from the authors.

PII: S0196-0644(08)01780-0

doi: 10.1016/j.annemergmed.2008.09.016

Annals of Emergency Medicine
Volume 53, Issue 2 , Pages 208-212 , February 2009

Article Tools