Prospective Study to Evaluate the Influence of FAST on Trauma Patient Management

Ollerton, J E; Sugrue, Michael; Balogh, Zsolt L; Sk, D'Amours; Giles, Andrew; Wyllie, Peter

doi:10.1097/01.ta.0000214583.21492.e8

Cited by 118 publications

(84 citation statements)

References 39 publications

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“…[1][2][3][4] There is a growing body of evidence that patient care is improved when FAST is included in the diagnostic workup of such patients. [5,6] Deployment of USG in prehospital care and Emergency Departments (EDs) could potentially provide critical information about traumatized patients and thereby optimize triage and transport of patients with multiple injuries. The portability, accuracy and noninvasiveness of USG create its potential as an effective imaging modality to provide diagnostic information in the prehospital arena.…”

Section: Resultsmentioning

confidence: 99%

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

Ünlüer¹,

Yavaşı²,

Kara³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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AMAÇTravmayı takiben acil servise başvuran hastalarda paramediklerce uygulanan travmaya odaklanmış ultrasonografi değerlendirmesinin (PFAST) serbest sıvı saptamadaki doğ-ruluğu araştırıldı. GEREÇ VE YÖNTEMDört saatlik teorik ve dört saatlik uygulamalı eğitim sonrası, dört paramedik travma hastalarını ileriye dönük inceledi. Altın standardımız ultrasonografi ve karın bilgisayarlı tomografisinin (KBT) resmi radyolog raporlarıydı. PFAST'in duyarlılık, seçicilik, pozitif ve negatif olabilirlik oranları ve tanısal odds oranı hesaplandı ve ki-kare testi ile SPSS 15.0 kullanılarak analiz edildi. BULGULARYüz yirmi yedi hasta paramedikler tarafından değerlendi-rildi. On dört hastada karında serbest sıvı vardı. Bunlardan 11 tanesi radyoloji raporlarıyla ve KBT ile uyumlu iken (gerçek pozitifler), üç tanesi negatif geldi (yanlış pozitifler). Yüz on üç olguda PFAST serbest sıvı için negatif idi. Bunlardan 111 tanesinde serbest sıvı yokken (gerçek negatifler), iki tanesinde KBT ile tespit edildi (yanlış negatifler). Sırasıyla duyarlılık, seçicilik, pozitif ve negatif olabilirlik oranları ve tanısal odds oranı 84,62, 97,37, 32,15, 0,16 ve 203,50 idi. SONUÇÇalışmamız, hastane acil servislerinde paramediklerin yük-sek doğruluk oranıyla FAST uygulayabileceklerini göster-mektedir.

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Section: Resultsmentioning

confidence: 99%

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

Ünlüer¹,

Yavaşı²,

Kara³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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“…19,20,40,41,[64][65][66][67][68] TFAST may be utilized as an adjunctive imaging modality to quickly support or refute physical examination findings and clinical suspicion regarding thoracic injury. Moreover, TFAST may be used as a point-of-care imaging technique, thus holding clinically important advantages over radiography because of its rapidity, high accuracy, portability, noninvasiveness, and radiation-sparing application.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

Lisciandro¹,

Lagutchik²,

Mann³

et al. 2008

J Vet Emergen Crit Care

116

132

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Objective: To estimate the relative accuracy of a thoracic focused assessment with sonography for trauma (TFAST) protocol for rapid diagnosis of pneumothorax (PTX) and other thoracic injury in traumatized dogs. Design: Prospective case series. Setting: Private veterinary emergency center. Animals: One hundred and forty-five client-owned dogs evaluated within 24-hours of injury. Interventions: Thoracic focused assessment with sonography for trauma protocol. Measurements and Main Results: Traumatized dogs were evaluated with a conventional ultrasound (US) machine using a standardized 4-point thoracic FAST protocol before thoracic radiography (CXR) and thoracocentesis. PTX was diagnosed by the absence of the 'glide sign,' defined as the lack of the normal dynamic interface between lung margins gliding along the thoracic wall during respiration. Concurrent thoracic trauma was diagnosed by the presence of pleural or pericardial fluid or the presence of a 'step sign,' defined as an abnormal glide sign. Accuracy of TFAST was calculated relative to CXR findings. Results: Overall sensitivity (Se), specificity (Sp), and accuracy of TFAST relative to CXR were 78.1% (95% CI; 61.5, 89.9), 93.4% (95% CI; 87.4, 97.1), and 90.0%, respectively. Se and Sp were higher in dogs with penetrating trauma (93.3%, 96.0%) and for the evaluator with the most clinical experience (95.2%, 96.0%); only Se between the most experienced compared with others was statistically significant (Po0.05). TFAST documented other concurrent thoracic injury. Median time for TFAST was 3 minutes. Conclusions and Clinical Relevance: TFAST has the potential to rapidly diagnose PTX and other thoracic injury and guide therapy, including potentially life-saving interventions, in traumatized dogs.

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“…In 2004, FAST was included in the ATLS procedure where it replaced diagnostic peritoneal lavage in the diagnostic work up of trauma patients. According to the study published by Ollerton et al [47], FAST has modified assessment of trauma patients in 33 % of cases.…”

Section: Abdomen and Peritoneum Fastmentioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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Prospective Study to Evaluate the Influence of FAST on Trauma Patient Management

Abstract: FAST plays a key role in trauma, changing subsequent management in an appreciable number of patients.

Cited by 118 publications

References 39 publications

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

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

Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

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