The FAST and extended FAST examinations
Keywords:
Ultrasonics, Wounds and injuries, Hemoperitoneum, Abdomen, Anesthesia
Abstract
The ultrasound is a useful, timely, and accessible tool to guide emergency patient care.
A systematic search was conducted in the following databases: Pubmed, Medline, SciELO, and Lilacs using the keywords ultrasonography, trauma, hemoperitoneum, and abdominal injury.
The main purpose of this review was to provide clear objectives and concepts on how to perform the FAST and FAST extended examinations properly, emphasizing the techniques that should be used and the appropriate ultrasonography windows. Photographs taken by the authors are included.
From this review, it can be concluded that there is enough evidence to recommend performing this procedure, with proven sensitivity and specificity ranging from 73 to 99%.
References
1. Kristensen JK, Buemann B, Kuehl E. Ultrasonic scanning in the diagnosis of splenic haematomas. Acta Chir Scand. 1971;137:653-7.
2. Asher WM, Parvin S, Virgilo RW. Echographic evaluation splenic injury after blunt trauma. Radiology. 1976;118:411-5.
3. Kimura A, Otsuka T. Emergency center ultrasonography in the evaluation of hemoperitoneum: a prospective study. J Trauma. 1991;31:20-3.
4. American College of Surgeons Committee on Trauma Abdominal trauma. In: Advanced Trauma Life Support Program for Doctors, (Instructor course manual). 6th ed. Chicago: American College of Surgeons Committee on Trauma; 1997.
5. McGahan JP, Wang L, Richards JR. From the SNA refresher courses: focused abdominal US for trauma. Radiographics. 2001;21:S191-9.
6. Branney SW, Wolfe RE, Moore EE, Albert NP, Heinig M, Mestek M, et al. Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma. 1995;39:375-80.
7. Ma OJ, Mateer JR. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. Ann Emerg Med. 1997;29:312-5.
8. Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned? Can J Surg. 2009;52:E173-9.
9. Melanson SW, The FAST. Exam: a review of the literature. In: Jehle D, Heller MB, editors. Ultrasonography in trauma: the FAST Exam. Dallas, TX: American College of Emergency Physicians; 2003. p. 127-45.
10. Brooks A, Davies B, Smethhurst M, Connolly J. Emergency ultrasound in the acute assessment of haemothorax. Emerg Med J. 2004;21:44-6.
11. Lee BC, Ormsby EL, McGahan JP, Melendres GM, Richards JR. The utility of sonography for the triage of blunt abdominal trauma patients to exploratory laparotomy. Am J Roentgenol. 2007;188:415-21.
12. Stengel D, Bauwens K, Rademacher G, Mutze S, Ekkernkamp A. Association between compliance with methodological standards of diagnostic research and reported test accuracy: meta-analysis of focused assessment of US for trauma. Radiology. 2005;236:102-11.
13. Quinn AC, Sinert R. What is the utility of the Focused Assessment with Sonograph in Trauma (FAST) exam in penetrating torso trauma? Injury. 2011;42:482-7.
14. Rozycki GS, Ballard RB, Feliciano DV, Schmidt JA, Pennington SD. Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann Surg. 1998;228:557-67.
15. Plummer D, Brunette D, Asinger R, Ruiz E. Emergency department echocardiography improves outcome in penetrating cardiac injury. Ann Emerg Med. 1992;21:709-12.
16. Rose JS, Richards JR, Battistella F, Bair AE, McGahan JP, Kuppermann N. Thefastis positive, now what? Derivation of a clinical decision rule to determine the need for therapeutic laparotomy in adults with blunt torso trauma and a positive trauma ultrasound. J Emerg Med. 2005;29:15-21.
17. Hoffmann R, Pohlemann T, Wippermann B, Reimer P, Milbradt H, Tscherne H. Management of sonography in blunt abdominal trauma. Unfallchirurg. 1989;92:471-6.
18. Williams S, Perera P, Gharahbaghian L. The FAST and E-FAST in 2013: trauma ultrasonography overview, practical techniques. Controversies and New Frontiers Crit Care Clin. 2014;30:119-50.
19. Bahner D, Blaivas M, Cohen HL, Fox JC, Hoffenberg S, Kendall J, et al. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med. 2008;27:2313-8.
20. Friese RS, Malekzadeh S, Shafi S, Gentilello LM, Starr A. Abdominal ultrasound is an unreliable modality for the detection of hemoperitoneum in patients with pelvic fracture. J Trauma. 2007;63:97-102.
21. Korner M, Krotz MM, Degenhart C, Pfeifer KJ, Reiser MF, Linsenmaier U. Current role of emergency US in patients with major trauma. Radiographics. 2008;28:225-42.
22. Kendall JL, Ramos JP. Fluid-filled bowel mimicking hemoperitoneum: a false positive finding during sonographic evaluation for trauma. J Emerg Med. 2003;25:79-82.
23. Sierzenski PR, Schofer JM, Bauman MJ, Nomura JT. The double-line sign: a false positive finding on the Focused Assessment with Sonography for Trauma (FAST) examination. J Emerg Med. 2011;40:188-9.
2. Asher WM, Parvin S, Virgilo RW. Echographic evaluation splenic injury after blunt trauma. Radiology. 1976;118:411-5.
3. Kimura A, Otsuka T. Emergency center ultrasonography in the evaluation of hemoperitoneum: a prospective study. J Trauma. 1991;31:20-3.
4. American College of Surgeons Committee on Trauma Abdominal trauma. In: Advanced Trauma Life Support Program for Doctors, (Instructor course manual). 6th ed. Chicago: American College of Surgeons Committee on Trauma; 1997.
5. McGahan JP, Wang L, Richards JR. From the SNA refresher courses: focused abdominal US for trauma. Radiographics. 2001;21:S191-9.
6. Branney SW, Wolfe RE, Moore EE, Albert NP, Heinig M, Mestek M, et al. Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma. 1995;39:375-80.
7. Ma OJ, Mateer JR. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. Ann Emerg Med. 1997;29:312-5.
8. Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned? Can J Surg. 2009;52:E173-9.
9. Melanson SW, The FAST. Exam: a review of the literature. In: Jehle D, Heller MB, editors. Ultrasonography in trauma: the FAST Exam. Dallas, TX: American College of Emergency Physicians; 2003. p. 127-45.
10. Brooks A, Davies B, Smethhurst M, Connolly J. Emergency ultrasound in the acute assessment of haemothorax. Emerg Med J. 2004;21:44-6.
11. Lee BC, Ormsby EL, McGahan JP, Melendres GM, Richards JR. The utility of sonography for the triage of blunt abdominal trauma patients to exploratory laparotomy. Am J Roentgenol. 2007;188:415-21.
12. Stengel D, Bauwens K, Rademacher G, Mutze S, Ekkernkamp A. Association between compliance with methodological standards of diagnostic research and reported test accuracy: meta-analysis of focused assessment of US for trauma. Radiology. 2005;236:102-11.
13. Quinn AC, Sinert R. What is the utility of the Focused Assessment with Sonograph in Trauma (FAST) exam in penetrating torso trauma? Injury. 2011;42:482-7.
14. Rozycki GS, Ballard RB, Feliciano DV, Schmidt JA, Pennington SD. Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann Surg. 1998;228:557-67.
15. Plummer D, Brunette D, Asinger R, Ruiz E. Emergency department echocardiography improves outcome in penetrating cardiac injury. Ann Emerg Med. 1992;21:709-12.
16. Rose JS, Richards JR, Battistella F, Bair AE, McGahan JP, Kuppermann N. Thefastis positive, now what? Derivation of a clinical decision rule to determine the need for therapeutic laparotomy in adults with blunt torso trauma and a positive trauma ultrasound. J Emerg Med. 2005;29:15-21.
17. Hoffmann R, Pohlemann T, Wippermann B, Reimer P, Milbradt H, Tscherne H. Management of sonography in blunt abdominal trauma. Unfallchirurg. 1989;92:471-6.
18. Williams S, Perera P, Gharahbaghian L. The FAST and E-FAST in 2013: trauma ultrasonography overview, practical techniques. Controversies and New Frontiers Crit Care Clin. 2014;30:119-50.
19. Bahner D, Blaivas M, Cohen HL, Fox JC, Hoffenberg S, Kendall J, et al. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med. 2008;27:2313-8.
20. Friese RS, Malekzadeh S, Shafi S, Gentilello LM, Starr A. Abdominal ultrasound is an unreliable modality for the detection of hemoperitoneum in patients with pelvic fracture. J Trauma. 2007;63:97-102.
21. Korner M, Krotz MM, Degenhart C, Pfeifer KJ, Reiser MF, Linsenmaier U. Current role of emergency US in patients with major trauma. Radiographics. 2008;28:225-42.
22. Kendall JL, Ramos JP. Fluid-filled bowel mimicking hemoperitoneum: a false positive finding during sonographic evaluation for trauma. J Emerg Med. 2003;25:79-82.
23. Sierzenski PR, Schofer JM, Bauman MJ, Nomura JT. The double-line sign: a false positive finding on the Focused Assessment with Sonography for Trauma (FAST) examination. J Emerg Med. 2011;40:188-9.
How to Cite
1.
Giraldo-Restrepo JA, Serna-Jiménez TJ. The FAST and extended FAST examinations. Colomb. J. Anesthesiol. [Internet]. 2015 Oct. 1 [cited 2024 May 1];43(4):299–306. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/343
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Published
2015-10-01
How to Cite
1.
Giraldo-Restrepo JA, Serna-Jiménez TJ. The FAST and extended FAST examinations. Colomb. J. Anesthesiol. [Internet]. 2015 Oct. 1 [cited 2024 May 1];43(4):299–306. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/343
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