title: Paramedic-performed Focused Assessment with Sonography in Trauma (FAST) in the emergency department.
abstract: BACKGROUND
  Our objective was to evaluate the accuracy of paramedic-performed Focused Assessment with Sonography in Trauma (PFAST) for detection of free fluid in patients admitted to the Emergency Department (ED) following trauma.
  
  
  METHODS
  After four hours of didactic and four hours of hands-on training, four paramedics prospectively evaluated trauma patients. Our gold standard was the official radiologist reports of ultrasonography and computerized abdominal tomography (CAT). The sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio of PFAST were calculated and analyzed using SPSS 15.0 with ?2 testing.
  
  
  RESULTS
  One hundred and twenty-seven patients were evaluated by the paramedics. Fourteen patients had positive free fluid in the abdomen. Of these, 11 were corroborated by radiology reports and CAT (true positives), and three were found to be negative (false positives). In 113 cases, PFAST was negative for free fluid. Of these, 111 were determined not to have free fluid (true negatives), whereas free fluid was detected by CAT in 2 (false negatives). The sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio of PFAST were 84.62, 97.37, 32.15, 0.16, and 203.50, respectively.
  
  
  CONCLUSIONS
  Our study shows that paramedics can perform FAST in hospital Eds with a high degree of accuracy.
authors.affiliation: Department of Emergency Medicine, İzmir Atatürk Training and Research Hospital, İzmir, Turkey. erdenun@yahoo.com
authors.forename: Erol Erden
authors.initials: EE
authors.lastname: Unlüer
authors.forename: Ozcan
authors.initials: O
authors.lastname: Yavaşi
authors.forename: Pınar Hanife
authors.initials: PH
authors.lastname: Kara
authors.forename: Turgay Yılmaz
authors.initials: TY
authors.lastname: Kılıç
authors.forename: Nergis
authors.initials: N
authors.lastname: Vandenberk
authors.forename: Kamil
authors.initials: K
authors.lastname: Kayayurt
authors.forename: Sevda
authors.initials: S
authors.lastname: Kıyançiçek
authors.forename: Haldun
authors.initials: H
authors.lastname: Akoğlu
authors.forename: Cengiz
authors.initials: C
authors.lastname: Yılmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel / Q000592:standards*; D001202:Ascitic Fluid / Q000000981:diagnostic imaging*; D004636:Emergency Service, Hospital; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010490:Pericardial Effusion / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014947:Wounds and Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D055815:Young Adult