How Accurate is Our FAST- 1 year review of FAST exam concordance with CT findings in patients with solid organ injury at a level 2 -community hospital trauma center

Abstract

Background Following ATLS protocols, focused assessment with sonography for trauma (FAST) is often the first diagnostic imaging modality as part of the primary survey patients with blunt trauma and generates an algorithm for the next stages in trauma triage. For those hemodynamically stable enough to tolerate further imaging, CT is performed to further evaluate organ injury. For the hemodynamically unstable patient, a positive FAST is an indication of internal hemorrhage and demands imminent intervention in the operating room. Per ACS TQIP, FAST exam has an acceptable sensitivity of 69–98% for detection of free fluid and 63% for detection of solid organ injury in adults. With such critical decision making being based on a user dependent imaging modality, we wanted to assess the accuracy and concordance of our FAST exam compared with trauma CT in patients with known solid organ injury.