FAST in the deployed military setting
- 10 April 2018
- journal article
- research article
- Published by BMJ in Journal of the Royal Army Medical Corps
- Vol. 164 (5), 332-334
- https://doi.org/10.1136/jramc-2018-000906
Abstract
Introduction Focused assessment with sonography in trauma (FAST) is historically an effective method of assessing the patient in the trauma bay in order to aid decision-making and optimise patient outcomes. However, in the UK civilian practice, the use of FAST may decline given a recent change in National Institute for Health and Care Excellence guidance as a result of improvement in CT availability and resuscitation techniques. Method In the Role 3 Medical Treatment Facility, Camp Bastion, 187 patients with trauma who received FAST in the trauma bay in 2014 were reviewed to determine the accuracy of FAST in the deployed environment. Results The data demonstrates the sensitivity and specificity of FAST to be 75% and 99.3%, respectively. Conclusions This study demonstrates that FAST is accurate on operations. FAST is provided by the integrated radiologist as part of damage control radiology, which gives the team leader rapid diagnostic information to improve decision-making and ultimately patient outcomes. CT is heavily utilised in civilian practice; however, the military operates in a different environment often with multiple casualties and limited access to CT, as a result, portable ultrasound will continue to be a valuable tool on operations if used properly. The next challenge is to develop and maintain this high diagnostic accuracy in future deployments where the memories of our prior success may fade.Keywords
This publication has 17 references indexed in Scilit:
- Scanning and WarAnnals of Surgery, 2015
- False-Negative FAST Examination: Associations With Injury Characteristics and Patient OutcomesAnnals of Emergency Medicine, 2012
- The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesionBMC Medical Imaging, 2009
- FAST on operational military deploymentEmergency Medicine Journal, 2005
- Not So FastThe Journal of Trauma and Acute Care Surgery, 2003
- 2,576 Ultrasounds for Blunt Abdominal TraumaThe Journal of Trauma and Acute Care Surgery, 2001
- Hemoperitoneum as the Sole Indicator of Abdominal Visceral Injuries: A Potential Limitation of Screening Abdominal US for TraumaRadiology, 1999
- Abdominal Injuries without HemoperitoneumThe Journal of Trauma and Acute Care Surgery, 1997
- A Prospective Study of Surgeon-Performed Ultrasound as the Primary Adjuvant Modality for Injured Patient AssessmentThe Journal of Trauma and Acute Care Surgery, 1995
- SONOGRAPHY IN BLUNT ABDOMINAL TRAUMAThe Journal of Trauma and Acute Care Surgery, 1992