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Abstract
Introduction
Previous studies have focused on the accuracy of the focused assessment with sonography
for trauma (FAST) examination performed in the emergency department (ED), but have
not evaluated FAST performed in the field setting (field FAST). We aimed to evaluate
the accuracy of field FAST by comparison with FAST performed in the ED.
Methods
A total of 1,380 trauma patients were admitted to our hospital by air ambulance between
April 2005 and October 2009. We compared the sensitivity and specificity of field
FAST with those of FAST in the hospital setting. The presence of pericardial and intraperitoneal
fluid was confirmed by the medical records.
Results
Of these patients, 317 blunt trauma patients (mean age, 43.9 ± 23.8 (SD) years) were
examined by field FAST and enrolled in the study; all participants were also examined
by FAST in the ED. The mean Injury Severity Score was 16.1 ± 15.4 (SD). Forty-seven
patients (14.8%) were ultimately diagnosed with pericardial and intraperitoneal fluid.
Field FAST detected 12 of these cases. The sensitivity of field FAST was significantly
lower than that of FAST in the ED (P < 0.01), whereas the specificities of FAST in
the two settings were not significantly different. Emergency surgery was performed
in nine of the 12 patients who were positive with field FAST.
Conclusions
Because the sensitivity of field FAST is low, repeated examination in ED is needed
to improve diagnostic sensitivity. However, field FAST may be an effective tool for
early detection of critical blunt trauma and as a rapid indicator for surgery.
Table 1
Field FAST
ED FAST
P value
Sensitivity
28.9%
66.7%
<0.01
Specificity
97.0%
96.6%
0.76