Sheng-Der Hsu1,2, Cheng-Jueng Chen3,4, De-Chuan Chan4, Jyh-Cherng Yu4. 1. Division of Traumatic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Taipei, 114, Taiwan, ROC. f1233j@yahoo.com.tw. 2. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. f1233j@yahoo.com.tw. 3. Division of Traumatic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Taipei, 114, Taiwan, ROC. 4. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Abstract
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments. METHODS: This was a retrospective study in the emergency department (ED) of our hospital performed from January 2011 to September 2013. Patients were included if they (1) had undergone a FAST examination performed by qualified residents and (2) had received subsequent formal radiographic or surgical evaluations. The results were compared against subsequent surgical findings or formal Department of Radiology reference standards. RESULTS: Among the 438 patients enrolled, false-negative results were obtained in 8 and false-positive results in 5. Only one patient was missed and required laparotomy to repair a small intestine perforation. The sensitivity and specificity were 87 and 99%, respectively; the accuracy was 97%. CONCLUSIONS: Senior general surgery residents can be trained to perform accurate FAST examinations on trauma patients.
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments. METHODS: This was a retrospective study in the emergency department (ED) of our hospital performed from January 2011 to September 2013. Patients were included if they (1) had undergone a FAST examination performed by qualified residents and (2) had received subsequent formal radiographic or surgical evaluations. The results were compared against subsequent surgical findings or formal Department of Radiology reference standards. RESULTS: Among the 438 patients enrolled, false-negative results were obtained in 8 and false-positive results in 5. Only one patient was missed and required laparotomy to repair a small intestine perforation. The sensitivity and specificity were 87 and 99%, respectively; the accuracy was 97%. CONCLUSIONS: Senior general surgery residents can be trained to perform accurate FAST examinations on traumapatients.
Entities:
Keywords:
Emergency department (ED); Focused assessment with sonography for trauma (FAST); Free fluid; Senior general surgery residents; Traumatic abdominal injury
Authors: T M Scalea; A Rodriguez; W C Chiu; F D Brenneman; W F Fallon; K Kato; M G McKenney; M L Nerlich; M G Ochsner; H Yoshii Journal: J Trauma Date: 1999-03
Authors: Dirk Stengel; Johannes Leisterer; Paula Ferrada; Axel Ekkernkamp; Sven Mutze; Alexander Hoenning Journal: Cochrane Database Syst Rev Date: 2018-12-12