Pediatric Blunt Abdominal Trauma and Point-of-Care Ultrasound

Blunt abdominal trauma (BAT) accounts for most trauma in children. Although the focused assessment with sonography in trauma (FAST) is considered standard of care in the evaluation of adults with traumatic injuries, there is limited evidence to support its use as an isolated evaluation tool for intra-abdominal injury as a result of BAT in children. Although a positive FAST examination could obviate the need for a computed tomography scan before OR evaluation in a hemodynamically unstable patient, a negative FAST examination cannot exclude intra-abdominal injury as a result of BAT in isolation. In this article, we review the evaluation of BAT in children, describe the evaluation for free intraperitoneal fluid and pericardial fluid using the FAST examination, and discuss the limitations of the FAST examination in pediatric patients.