The accuracy of focused assessment with sonography in trauma (FAST) in blunt trauma patients: experience of an Australian major trauma service.
Focused assessment with sonography for trauma (FAST) is a method for detecting haemoperitoneum in trauma patients on initial assessment in the Emergency Department. The aim of this paper is to present an Australian trauma centre's experience with FAST as a tool to screen for intraabdominal free fluid in patient's sustaining blunt truncal trauma.


METHODS
Over a 63-month period, FAST scans were prospectively studied and compared with findings from a gold-standard investigation, either computed tomography (CT) or laparotomy.


RESULTS
463 FAST results were collected prospectively from 463 patients. 53 scans were excluded due to lack of a corresponding confirmatory gold-standard test. Overall sensitivity, specificity, positive and negative predictive values for FAST in detecting free fluid were 78%, 97%, 91%, 93%, respectively. Analysis of the credentialed operators demonstrated an improvement in accuracy (sensitivity 80%, specificity 100%, positive predictive value 100%, negative predictive value 94%). These findings are comparable with documented international experience.


CONCLUSIONS
The study demonstrates that the use of non-radiologist performed FAST in the detection of free fluid is safe and accurate within an Australian Trauma Centre.
Hsu
Jeremy M
JM
Department of Surgery, Royal North Shore Hospital, NSW, Australia.
Joseph
Anthony P
AP
Tarlinton
Lisa J
LJ
Macken
Lewis
L
Blome
Steven
S
D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D003951:Diagnostic Errors; D004502:Education, Medical, Continuing / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D006465:Hemoperitoneum / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000209:etiology