title: [Impact of the practice of "Extended Focused Assessment with Sonography for Trauma" (e-FAST) on clinical decision in the emergency department].
abstract: BACKGROUND
  We aimed to show the sensitivity of Extended Focused Assessment with Sonography for Trauma (e-FAST) for detection of pneumothorax, hemothorax and intraabdominal injury. We also investigated the relationship between e-FAST and need for invasive treatment.
  
  
  METHODS
  This study included patients who experienced multiple trauma. The emergency physician, who had no clinical information about the patient, performed e-FAST. Findings on a supine chest X-ray and invasive interventions were recorded. The results of abdomen and thorax computed tomography (CT) were reviewed (the size of the pneumothorax was scored).
  
  
  RESULTS
  Compared with CT, the sensitivities of e-FAST for intraabdominal injury and hemothorax were 54.5% and 71%, respectively. The patients with hemothorax and intraabdominal injuries were not identified with e-FAST, didn't need for invasive intervention. Pneumothorax diagnosis was established in 27 patients with e-FAST (sensitivity 81.8%) from among 33 (30.8%) pneumothorax patients. According to the grading on CT, pneumothoraces less than 1 cm in width and not exceeding the midcoronal line in length were not identified. e-FAST was positive for all patients performed with tube thoracostomy.
  
  
  CONCLUSIONS
  e-FAST can be used with high sensitivity for determination of pneumothorax requiring invasive procedure. It has low sensitivity in the diagnosis of intraabdominal injury and hemothorax; however, e-FAST can predict the need for invasive procedures.
authors.affiliation: Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Uz
authors.forename: Aslıhan
authors.initials: A
authors.lastname: Yürüktümen
authors.forename: Bahar
authors.initials: B
authors.lastname: Boydak
authors.forename: Selen
authors.initials: S
authors.lastname: Bayraktaroğlu
authors.forename: Enver
authors.initials: E
authors.lastname: Ozçete
authors.forename: Ozgür
authors.initials: O
authors.lastname: Cevrim
authors.forename: Murat
authors.initials: M
authors.lastname: Ersel
authors.forename: Selahattin
authors.initials: S
authors.lastname: Kıyan
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011859:Radiography; D014463:Ultrasonography; D055815:Young Adult