[Ultrasound in trauma (FAST)]

Area of Science:

• Emergency Medicine
• Diagnostic Imaging
• Trauma Surgery

Background:

• Ultrasonography has been a standard for abdominal trauma evaluation in Europe for two decades.
• Historically, the United States questioned its reliability for diagnosing parenchymal injuries due to sensitivity concerns.
• Recent reevaluation has led to the adoption of a standardized protocol in the US.

Purpose of the Study:

• To introduce and validate the Focused Assessment for the Sonographic examination of Trauma patients (FAST) protocol.
• To detect the presence of hemoperitoneum (blood in the abdomen) and pericardial effusion (fluid around the heart) in trauma patients.
• To highlight the benefits of ultrasound in emergency trauma assessment.

Main Methods:

• Implementation of the FAST protocol, a standardized ultrasound examination.
• Focus on rapid sonographic assessment at the bedside.
• Integration into the Advanced Trauma Life Support (ATLS) framework.

Main Results:

• FAST enables the detection of critical findings like hemoperitoneum and pericardial effusion.
• Ultrasound is recognized as a cost-effective, rapid, and non-invasive diagnostic tool.
• The procedure can be performed by surgeons on unstable patients, improving immediate care decisions.

Conclusions:

• The FAST examination has been codified and integrated into trauma care protocols in the United States.
• Ultrasonography, through the FAST exam, is now a reliable and essential component of thoraco-abdominal trauma evaluation.
• FAST offers significant advantages in speed, cost, and patient safety for trauma assessment.