The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war.
OBJECTIVE
The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict.


METHODS
The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records.


RESULTS
Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P < .05).


CONCLUSIONS
In a setting of a war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.
Beck-Razi
Nira
N
Department of Medical Imaging, Rambam Medical Center, Haifa, Israel.
Fischer
Doron
D
Michaelson
Moshe
M
Engel
Ahuva
A
Gaitini
Diana
D
D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007861:Lebanon; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014218:Triage; D014463:Ultrasonography; D014857:Warfare