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Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
07:18

Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition

Published on: September 22, 2023

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Focused assessment with sonography for trauma in predicting early surgical intervention in hemodynamically unstable

Megan K Long1, Mohammed K Vohra1, Austin Bonnette1

  • 1Department of Emergency Medicine The University of Texas Health Science Center at Houston McGovern Medical School Houston Texas USA.

Journal of the American College of Emergency Physicians Open
|February 7, 2022
PubMed

Insights

The focused assessment with sonography for trauma (FAST) exam accurately predicts early surgical intervention in pediatric blunt abdominal trauma. Its accuracy for detecting free fluid in hemodynamically unstable patients improves within 2 hours of emergency department arrival.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Trauma Surgery

Background:

  • The clinical utility of the focused assessment with sonography for trauma (FAST) exam in pediatric blunt abdominal trauma remains unclear.
  • Predicting the need for early surgical intervention and identifying free fluid (FF) are critical in managing these patients.

Purpose of the Study:

  • To evaluate the predictive accuracy of the emergency department (ED) FAST exam.
  • To determine the role of the FAST exam in predicting early surgical intervention and FF in pediatric trauma patients.

Main Methods:

  • Retrospective review of pediatric trauma patients (0-15 years) with blunt torso trauma.
  • Stratification based on initial hemodynamic (HD) instability.
  • Association analysis of positive FAST exam with early surgical intervention and FF.

Main Results:

  • Of 508 patients, 8.3% required early surgical intervention; FAST sensitivity was 59.5% and specificity 84.3%.
  • FAST-positive, hemodynamically unstable patients showed improved FF detection specificity and PPV within 2 hours (100% and 100%) versus 4 hours (50% and 90.9%).

Conclusions:

  • A positive FAST exam enhances the prediction of early surgical intervention in injured children.
  • The accuracy of FAST for detecting FF in hemodynamically unstable pediatric trauma patients is significantly greater within 2 hours of ED arrival.
Abstract

Keywords:
FAST examabdominal/gastrointestinalangiographyblunt injuryfocused assessment with sonography for traumahypotensionlaparotomypediatric emergency medicinepediatric resuscitationpediatric traumapediatricspericardiostomytherapeutic embolizationtraumatic brain injuryultrasound

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