The efficacy of modified focused assessment with sonography for trauma: a pilot study

ABSTRACT

OBJECTIVE: Focused assessment with sonography for trauma (FAST) is used routinely for evaluating patients with major trauma. After a primary survey, the existence of hemoperitoneum or hemopericardium must be searched using FAST. Traditionally, hemopericardium can be assessed through the subcostal approach with the curved probe for the abdomen. On the other hand, satisfactory images (four chamber view) are difficult to obtain with this approach. METHODS: This was a prospective, single-center pilot study of an academic tertiary medical center. When FAST is performed on the patients, traditional FAST (subcostal approach with the curved probe) is generally conducted. During a FAST examination, the time consumed, numeric rating scale (NRS) for pain, and success rate of satisfactory images are recorded. After the traditional FAST was used, we used the curved probe like echo probe. The curved probe was positioned beside the left nipple with the probe marker opposite-sided (modified FAST) like the parasternal long-axis view of echocardiography. Finally, the existence of hemopericardium is confirmed using an echo probe. In this study, the consumed time, NRS, and success rate of satisfactory images were compared. RESULTS: The consumed time was shorter (57.4 vs. 71.2 seconds, P<0.001) and the pain score was lower (0.1 vs. 1.8, P<0.001) with the modified FAST compared to the traditional FAST. Satisfactory images were obtained in 23 cases (51%) with traditional FAST, whereas satisfactory images were obtained in 37 cases (82%) using modified FAST. CONCLUSION: Mvodified FAST is more accurate for the detection of hemopericardium than traditional FAST. The pain is less severe and the time consumed is shorter.