eFAST exam errors at a level 1 trauma center: A retrospective cohort study

Area of Science:

• Emergency Medicine
• Diagnostic Imaging
• Trauma Care

Background:

• Extended Focused Assessment with Sonography for Trauma (eFAST) is crucial for unstable trauma patients.
• Quality assurance is essential for maintaining the accuracy of eFAST examinations.

Purpose of the Study:

• To identify common causes of false positive and false negative eFAST exams.
• To analyze six years of eFAST quality assurance data.

Main Methods:

• Retrospective observational cohort study.
• Analysis of eFAST exams from trauma activation patients at a Level 1 trauma center.
• Comparison of eFAST findings with computed tomography (CT) imaging.

Main Results:

• Over 4800 eFAST exams were reviewed; 29.8% were incomplete or undocumented.
• False positive rate was 0.79% and false negative rate was 2.19% after exclusions.
• Common error sources included pelvic fluid, double-line sign, pericardial fat pad, and thoracic eFAST views.

Conclusions:

• eFAST exams demonstrate high accuracy in trauma patients.
• Poor documentation and technical limitations significantly impact eFAST exam quality.
• Specific anatomical findings are frequent sources of diagnostic errors in eFAST.