A W Kirkpatrick1, R K Simons, D R Brown, A K Ng, S Nicolaou. 1. Trauma Services, Vancouver Hospital & Health Sciences Centre, 3rd Floor, 855 West 10th Avenue, Vancouver, British Columbia V5Z 1L7, Canada. akirkpat@vanhosp.bc.ca
Abstract
OBJECTIVE: To evaluate the accuracy of the focused assessment with sonography for trauma (FAST) exam performed with a digital hand-held ultrasound machine in the emergency evaluation and resuscitation of trauma victims. INTRODUCTION: The FAST exam is a valuable screening tool in the evaluation of abdominal trauma. New digital ultrasound units have recently become available which can be hand-carried by clinicians responding to the earliest phases of trauma care. MATERIALS AND METHODS: Forty-seven victims of blunt trauma and 3 victims of penetrating trauma underwent FAST examinations performed by an attending trauma surgeon. Scans were performed with a Sonosite 180, 2.4-kg machine utilising a 5-2 MHz curved array transducer. The results of the hand-held FAST were compared with formal sonographic examinations performed by radiology department personnel, computed tomographic (CT) studies, operative findings and ultimate hospital course. RESULTS: In victims of blunt trauma, 7 of 8 true fluid collections were detected, and 38 out of 39 cases without the presence of fluid were correctly excluded. There was 1 false positive and 1 false negative determination, resulting in a sensitivity of 86%, specificity of 97%, positive predictive value of 88%, and a negative predictive value of 97%. The overall accuracy was 96% for victims of blunt trauma. The technique expediently detected intra-peritoneal bleeding in 2 victims of lateral penetrating abdominal trauma. Utilised as the initial component of a diagnostic protocol, no inappropriate management strategies were suggested. CONCLUSIONS: Digital hand-held sonography by clinicians can accurately allow the early performance of FAST exams. This exam may accurately and safely extend the physical senses of the examining physician.
OBJECTIVE: To evaluate the accuracy of the focused assessment with sonography for trauma (FAST) exam performed with a digital hand-held ultrasound machine in the emergency evaluation and resuscitation of trauma victims. INTRODUCTION: The FAST exam is a valuable screening tool in the evaluation of abdominal trauma. New digital ultrasound units have recently become available which can be hand-carried by clinicians responding to the earliest phases of trauma care. MATERIALS AND METHODS: Forty-seven victims of blunt trauma and 3 victims of penetrating trauma underwent FAST examinations performed by an attending trauma surgeon. Scans were performed with a Sonosite 180, 2.4-kg machine utilising a 5-2 MHz curved array transducer. The results of the hand-held FAST were compared with formal sonographic examinations performed by radiology department personnel, computed tomographic (CT) studies, operative findings and ultimate hospital course. RESULTS: In victims of blunt trauma, 7 of 8 true fluid collections were detected, and 38 out of 39 cases without the presence of fluid were correctly excluded. There was 1 false positive and 1 false negative determination, resulting in a sensitivity of 86%, specificity of 97%, positive predictive value of 88%, and a negative predictive value of 97%. The overall accuracy was 96% for victims of blunt trauma. The technique expediently detected intra-peritoneal bleeding in 2 victims of lateral penetrating abdominal trauma. Utilised as the initial component of a diagnostic protocol, no inappropriate management strategies were suggested. CONCLUSIONS: Digital hand-held sonography by clinicians can accurately allow the early performance of FAST exams. This exam may accurately and safely extend the physical senses of the examining physician.
Authors: Stanislaw Peter Stawicki; James M Howard; John P Pryor; David P Bahner; Melissa L Whitmill; Anthony J Dean Journal: World J Orthop Date: 2010-11-18
Authors: Andrew W Kirkpatrick; Marco Sirois; Kevin B Laupland; Leanelle Goldstein; David Ross Brown; Richard K Simons; Scott Dulchavsky; Bernard R Boulanger Journal: Can J Surg Date: 2005-12 Impact factor: 2.089
Authors: Lawrence M Gillman; Chad G Ball; Nova Panebianco; Azzam Al-Kadi; Andrew W Kirkpatrick Journal: Scand J Trauma Resusc Emerg Med Date: 2009-08-06 Impact factor: 2.953