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Updated: Sep 16, 2025
Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
Published on: September 22, 2023
Serial Trauma Abdominal Ultrasound in Children (STAUNCH): Assessment of Utilization
Benjamin K Nti1, Pamela Soriano, Sean Thompson
1Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
Insights
Serial Focused Assessment with Sonography for Trauma (sFAST) exams are viewed as useful in pediatric trauma care but are underutilized. Barriers include perceived lack of efficacy and infrequent changes in management, hindering routine use.
Area of Science:
- Pediatric Emergency Medicine
- Point-of-Care Ultrasound (POCUS)
Background:
- Point-of-care ultrasound (POCUS) offers radiation-free diagnostic capabilities in pediatric emergency medicine (PEM).
- The serial Focused Assessment with Sonography for Trauma (sFAST) examination is an underutilized tool in pediatric trauma evaluations.
Purpose of the Study:
- To assess current practices and viewpoints regarding the use of serial ultrasound examinations in pediatric trauma patients.
- To identify barriers to the routine implementation of serial FAST examinations in PEM.
Main Methods:
- A survey was distributed to 33 PEM institutions, targeting faculty and staff involved in POCUS programs.
- Data collected included institutional demographics, attitudes, and practices concerning serial FAST examinations.
Main Results:
- 75.8% of respondents found serial ultrasound useful for pediatric trauma.
- The primary barriers identified were insufficient evidence of efficacy (50%) and the perception that it infrequently changed management (78.9%).
- Serial FAST examinations are not routinely performed, with only one institution having a formal protocol.
Conclusions:
- Institutional support exists for serial FAST examinations in pediatric trauma evaluations.
- Significant barriers, including perceived lack of efficacy and impact on management, prevent routine utilization.
- Further research and evidence are needed to overcome barriers and promote the routine use of sFAST in pediatric trauma.
Objectives:
Point-of-care ultrasound has established utility within pediatric emergency medicine (PEM) and has the added benefit of avoiding excessive radiation exposure. The serial Focused Assessment with Sonography for Trauma (sFAST) examination is an underutilized tool in pediatric trauma patients. We sought to understand current practices and viewpoints regarding serial ultrasound (US) examinations.
Methods:
Thirty-three PEM institutions were surveyed regarding attitudes and practices toward serial FAST examination. We included all faculty and staff who had oversight or leadership in a POCUS program. We were provided with basic demographic data from institutions through our survey.
Results:
Among institutions that performed serial FAST examinations, the region with the highest number of respondents was the Northeast (38.7%). In total, 75.8% of respondents noted that serial ultrasound was a useful tool in pediatric trauma. The most common barrier was insufficient evidence for efficacy (50%), with the perception that it infrequently changed management (78.9%). Serial FAST was not routinely performed, and only one institution had a protocol for it.
Conclusions:
Although there is institutional support for serial FAST examinations as part of trauma evaluations, several barriers remain that hinder their routine use in pediatric trauma patients.
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