The Effect of BMI on eFAST Accuracy in Trauma by Residents in the Emergency Room

Blunt trauma patients are often evaluated with extended focused assessment with sonography for trauma (eFAST). eFAST is a noninvasive, rapid, ultrasound-guided assessment for hemoperitoneum, pericardial effusion, and hemopneumothorax. Specificity and sensitivity are as high as 95% and 74%, respectively. Research suggests obesity confers increased morbidity and mortality and is an independent risk factor for trauma death. A previous study demonstrated that a BMI change from 36 to 40 changed the odds ratio for inaccurate eFAST from 1.85 to 3.12. Our current prospective data collection is 202 consecutive blunt trauma patients from 5/13/22 to 8/18/22 receiving an eFAST and a CT/OR for comparison. Odds ratio of inaccurate eFAST increased by 5.65% for each increase of 1 kg/m3 of BMI (95% Cl 0.1%-10.8%). This research also investigated surgical resident eFAST accuracy to improve patient outcomes through the implementation of individualized training in normal and obese models.