Abnormal urinalysis finding triggered antibiotic prescription for asymptomatic bacteriuria in the ED.

postintervention progress was uneventful. Because US is portable, rapid, noninvasive, irradiation free, easy to perform, and can be used repeatedly, it is the initial examination performed. In stable critically ill patients, negative or positive US is followed by a CT scan or CT angiography. In hemodynamically unstable patients, US is followed by an emergency exploratory laparotomy or an angiographic procedure [4]. However, the limits of this technique must be recognized. The study by Sirlin et al [2] showed that among 3679 patients with blunt abdominal trauma and negative screening US scans, 99.9% were true negative, and 36 patients were false negative, including 24 patients who were nonsurgical. The 6 most common missed injuries included RH (n = 13) and injuries to the spleen (n = 10), liver (n = 9), kidney (n = 8), adrenal gland (n = 8), and small bowel (n = 7) [2]. Moreover, although our examples show important RH localized in the flanks (zone 2), US seems to fail to detect RH in the centralmedian (zone 1) or pelvic (zone 3) area [5]. Ultrasonography can be of use in triage and initial diagnostic assessment because it reduces the time needed to prepare for an angiographic procedure or laparotomy. Despite the high clinical value of negative-screening US scans, this technique has a limitation, which is the detection of parenchymal abnormalities or RH. Nevertheless, their imaging is possible, and the technique must be taught to improve the management of critically ill patients and to gain time.