• A W Kirkpatrick, R K Simons, D R Brown, A K Ng, and S Nicolaou.
• Trauma Services, Vancouver Hospital & Health Sciences Centre, 3rd Floor, 855 West 10th Avenue, Vancouver, British Columbia V5Z 1L7, Canada. akirkpat@vanhosp.bc.ca
• Ann Acad Med Singap. 2001 Nov 1;30(6):577-81.

ObjectiveTo evaluate the accuracy of the focused assessment with sonography for trauma (FAST) exam performed with a digital hand-held ultrasound machine in the emergency evaluation and resuscitation of trauma victims.IntroductionThe FAST exam is a valuable screening tool in the evaluation of abdominal trauma. New digital ultrasound units have recently become available which can be hand-carried by clinicians responding to the earliest phases of trauma care.Materials And MethodsForty-seven victims of blunt trauma and 3 victims of penetrating trauma underwent FAST examinations performed by an attending trauma surgeon. Scans were performed with a Sonosite 180, 2.4-kg machine utilising a 5-2 MHz curved array transducer. The results of the hand-held FAST were compared with formal sonographic examinations performed by radiology department personnel, computed tomographic (CT) studies, operative findings and ultimate hospital course.ResultsIn victims of blunt trauma, 7 of 8 true fluid collections were detected, and 38 out of 39 cases without the presence of fluid were correctly excluded. There was 1 false positive and 1 false negative determination, resulting in a sensitivity of 86%, specificity of 97%, positive predictive value of 88%, and a negative predictive value of 97%. The overall accuracy was 96% for victims of blunt trauma. The technique expediently detected intra-peritoneal bleeding in 2 victims of lateral penetrating abdominal trauma. Utilised as the initial component of a diagnostic protocol, no inappropriate management strategies were suggested.ConclusionsDigital hand-held sonography by clinicians can accurately allow the early performance of FAST exams. This exam may accurately and safely extend the physical senses of the examining physician.

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