OBJECTIVE: The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict. METHODS: The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records. RESULTS: Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P < .05). CONCLUSIONS: In a setting of a war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.
OBJECTIVE: The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict. METHODS: The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records. RESULTS: Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P < .05). CONCLUSIONS: In a setting of a war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.
Authors: Markus Körner; Michael M Krötz; Stefan Wirth; Stefan Huber-Wagner; Karl-Georg Kanz; Holger F Boehm; Maximilian Reiser; Ulrich Linsenmaier Journal: Eur Radiol Date: 2009-03-11 Impact factor: 5.315
Authors: Justin W Timbie; Jeanne S Ringel; D Steven Fox; Francesca Pillemer; Daniel A Waxman; Melinda Moore; Cynthia K Hansen; Ann R Knebel; Richard Ricciardi; Arthur L Kellermann Journal: Ann Emerg Med Date: 2013-03-20 Impact factor: 5.721
Authors: Dirk Stengel; Johannes Leisterer; Paula Ferrada; Axel Ekkernkamp; Sven Mutze; Alexander Hoenning Journal: Cochrane Database Syst Rev Date: 2018-12-12
Authors: Michel Debacker; Ives Hubloue; Erwin Dhondt; Gerald Rockenschaub; Anders Rüter; Tudor Codreanu; Kristi L Koenig; Carl Schultz; Kobi Peleg; Pinchas Halpern; Samuel Stratton; Francesco Della Corte; Herman Delooz; Pier Luigi Ingrassia; Davide Colombo; Maaret Castrèn Journal: PLoS Curr Date: 2012-03-23