Is the FAST Exam Actually Fast? Utilizing Trauma Video Review to Assess FAST User Performance.

Area of Science:

• Emergency Medicine
• Radiology
• Surgical Education

Background:

• The Focused Assessment with Sonography for Trauma (FAST) is a critical diagnostic tool in trauma care.
• Proficiency of surgical trainees in performing FAST exams requires further investigation.

Purpose of the Study:

• To assess the performance of surgical trainees in conducting FAST exams using trauma video review (TVR).
• To evaluate the diagnostic quality, technical skill, and accuracy of FAST exams performed by surgical trainees.

Main Methods:

• A cross-sectional study analyzed 93 blunt trauma FAST exams recorded via TVR.
• Radiologists assessed diagnostic quality and technical technique using a Task Specific Checklist (TSC).
• FAST findings were compared with CT scans and surgical outcomes for accuracy assessment.

Main Results:

• Trainees completed FAST exams within a median net time of 2.33 minutes.
• Approximately 80% of exams had at least one non-diagnostic FAST window, with average scores indicating moderate improvement needed.
• Diagnostic accuracy for detecting intraperitoneal free blood was 54% sensitivity and 92% specificity.

Conclusions:

• Surgical trainees demonstrate timely completion of FAST exams but require significant improvements in image quality and diagnostic accuracy.
• Findings underscore the necessity for enhanced training programs to optimize FAST exam performance in surgical education.