1. [Impact of the practice of "Extended Focused Assessment with Sonography for Trauma" (e-FAST) on clinical decision in the emergency department].
- Author
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Uz I, Yürüktümen A, Boydak B, Bayraktaroğlu S, Ozçete E, Cevrim O, Ersel M, and Kıyan S
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Emergency Service, Hospital, Female, Humans, Infant, Injury Severity Score, Male, Middle Aged, Radiography, Ultrasonography, Young Adult, Abdominal Injuries diagnostic imaging, Emergency Medicine methods, Multiple Trauma diagnostic imaging, Pneumothorax diagnostic imaging
- 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., Conclusion: 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.
- Published
- 2013
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