Rectal Tone


Rectal Tone

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It sounds like the name of an awesome punk band from the '80s. But alas, it is not or at least not that I have ever had the pleasure of listening to. A rectal tone or technically referred to as a digital rectal exam (DRE), is an assessment that is most often performed by physicians used to detect spinal injury associated with trauma or bleeding from some mechanism or another. This is an exam that ATLS suggests and refers to as the DRE. I have often wondered if this is an assessment paramedics should perform in the wake of a traumatic event. 


  First thing to ask; will this assessment change your treatment? If we can prove that outcomes are increased by performing a DRE, maybe this is something to discuss. However, if it is not, then perhaps someone should start a band instead. So, guess what? I looked and found a few articles to support my theory and found that these DREs have little impact on outcome and should be reserved for docs in the emergency department who feel it necessary.  


  Here is my humble suggestion - avoid this exam, do a proper rapid trauma assessment or MARCH, and if you think your patient needs a DRE, transport him or her to definitive care. After you have dropped the patient off and given him or her the best chance, go back to your ambulance and write a bad "ass" song to start promoting your new band, The Rectal Tones.


Regards,

Aaron