Focused Assessment Sonography for Trauma (FAST) training: a systematic review

Area of Science:

• Emergency Medicine
• Medical Education
• Point-of-Care Ultrasound

Background:

• Focused Assessment Sonography for Trauma (FAST) is a critical skill in emergency medicine.
• Current training methodologies and credentialing requirements for FAST vary significantly.
• A systematic review is needed to evaluate existing FAST training approaches.

Purpose of the Study:

• To systematically review training methods for Focused Assessment Sonography for Trauma (FAST).
• To analyze FAST course design and duration.
• To examine hospital credentialing requirements for FAST proficiency.

Main Methods:

• Systematic literature search of MEDLINE/PubMed, EMBASE, and Cochrane databases.
• Manual search of relevant papers and abstracts in English.
• Critical evaluation of studies focusing on FAST training models, hours, practice exams, and credentialing case numbers.

Main Results:

• 52 studies were analyzed, with theoretical components averaging 4 hours and practical components averaging 4 hours.
• Participants performed a median of 10 FAST exams during courses.
• Normal human models were most common (65%), followed by peritoneal dialysis patients (27%); animal (4%) and cadaveric (2%) models were least used.
• Credentialing typically required a median of 50 FAST exams.

Conclusions:

• Standardization of FAST training is essential for enhancing clinical impact.
• Various training models (human, animal, cadaveric, simulators) offer complementary benefits.
• Recommended FAST courses should be at least 16 hours (2 days), incorporating theory, practical training on human models, and simulation or case scenarios.