Not So Fast

Abstract

Use of FAST examination as a screening tool for BAI in the hemodynamically stable trauma patient results in underdiagnosis of intra-abdominal injury. This may have an impact on treatment and outcome in trauma patients. Hemodynamically stable patients with suspected BAI should undergo routine CT scanning.

Paramedic Performed Focused Assesment with Sonography in Trauma (FAST) in the Emergency Department

“…[2,[15][16][17][18][19][20][21][22][23][24][25] The results of our study suggest that the accuracy of FAST performed by paramedics working in the ED, and trained in FAST, is comparable to non-radiologist-performed FAST. To our knowledge, this is the first study to assess the accuracy of FAST when performed by paramedics in the ED, trained in the performance and interpretation of FAST.…”

Impact of the practice of "Extended Focused Assessment with Sonography for Trauma" (e-FAST) on clinical decision in the emergency department

“…GATUS ile saptanamayan, ancak BT'de hemotoraks gözlenen hastaların hiçbirisine TT uygulanmadığı gözlenmiştir. TARTIŞMA Travma hastalarının yönetiminde, "FAST"in etkinliğini sorgulayan erken dönem araştırmalardan Miller ve arkadaşlarının [13] çalışmalarında duyarlılık %42, olumlu öngörü değeri %67 olarak saptanmıştır. Parankimal organ hasarı ile serbest sıvı saptama yeterliliği-ni ayırarak değerlendiren ileriye dönük bir radyoloji çalışmasında ise, 3264 hastanın, 288'inde intraperitoneal kanama saptanmış, USG ile serbest sıvı saptama duyarlılığı %60, özgüllüğü %98; serbest sıvı ve/veya karıniçi organ yaralanmalarını göstermedeki duyarlılı-ğı %67, özgüllüğü %98 olarak bulunmuştur.…”

Non-operative treatment approach for blunt splenic injury: is grade the unique criterion?

“…[13] The risk of false-positives in patients with hematuria and pelvic and vertebral fracture is high. [14] Since it is a fast and easy-to-use method for patients with impaired hemodynamics, it may be the first choice for diagnosis. In most trauma centers, US is used to monitor low-grade splenic injuries.…”

“…[14,21] The radiological grade of the injury is an important criterion. However, in well-selected cases, patients over 55 years, with grade-4 splenic traumas and with extra-splenic injuries could also be treated successfully with the Fig.…”