F.A.S.T. Ultrasound for Emergency Surgeon

Abstract

INTRODUCTION: F.A.S.T. (Focused Assessment with Sonography for Trauma) is an ultrasound investigation that can discover presence of peritoneal fluid. The availability of an investigation that can be used directly at the patient bed optimizes the Emergency Room Service. The learning curve is short and all doctors working in Emergency Room can use it.

AIM OF THE STUDY: End point of the study was to evaluate the applicability of fast to our hospital, to study it’s efficacy when compared to other investigations and to produce a flow chart for patients with abdominal trauma.

MATERIAL AND METHODS: From July 2002 we evaluate 400 consecutive patients with medium - high grade abdominal trauma. After ATLS we investigate the patient with FAST Ultrasound. Patients with indication to immediate laparotomy (ATLS Flow Chart) where evaluated only with FAST and send to the operating theatre. All others patients follows the normal abdomial trauma flow chart as in use in our Emergency Room.

RESULTS: We performed 2 immediate laparotomy (0.5%) and 8 (2%) after the results of investigations. In group of immediately laparotomy FAST ultrasound confirmed the presence of haemoperitoneum (Sensibility and Specificity of 100%). In the other group (not immediately laparotomy) in 6 over 8 cases FAST Ultrasiound was in accord with other conventional radiological investigations (Sensibility 75%, Specificity 100%). In 2 over 8 patients only TC permitted to evidence intrabdominal damage not seen by FAST (MesoColon Haemathom and Gastric Rupture).

CONCLUSIONS: FAST ultrasound resulted an effective and reliable investigation to evidence abdominal fluid when compared with other radiological investigations. We hope this tipe of investigation will be adopted in all Emergency Room.