Use of Focused Assessment with Sonography in Trauma in Emergency Department Patients for Triage, Diagnosis and Disposition: A Series of Cases

Abstract

Objective: The aim of this study was to determine the effectiveness of fo cused assessment with sonography in blunt trauma (FAST) patients as an initial diagnostic and observational tool. Material and Methods: This descriptive prospective study was performed by collecting data from patients with blunt trauma who presented to our tertiary university hospital emergency department (ED) between October 2008 and December 2008 and who were evaluated with ultrasound by the treating emergency medicine physician (GE Proseries Logic 200 machine with a 3.5 MHz large curved array probe). Demographic, clinical, laboratory, and imaging data were collected prospectively and ISS, RTS, TRISS, and Glasgow scores were calculated. Results: During the study period, 28 patients presented with blunt trauma and they were evaluated with a bedside ultrasound within 10 minutes. Only one patient had splenic trauma and two had pleural fluid on FAST exam. The FAST results correlated positively with the decrease in hematocrit (Htc) values, ISS, TRISS, and duration of admission (p=0.006, 0.01, 0.034, 0.009). 96.4% (n=27) of the patients were discharged, and 3.6% (n=1) died. Conclusion: FAST was the first and an observational clue for trauma before Htc, or even physical examination. (JAEM 2011; 10: 119-22)