JUM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Beck-Razi, N.
Right arrow Articles by Gaitini, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Beck-Razi, N.
Right arrow Articles by Gaitini, D.
© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1149-1156 • 0278-4297

The Utility of Focused Assessment With Sonography for Trauma as a Triage Tool in Multiple-Casualty Incidents During the Second Lebanon War

Nira Beck-Razi, MD, Doron Fischer, MD, Moshe Michaelson, MD, Ahuva Engel, MD and Diana Gaitini, MD

Department of Medical Imaging (N.B.-R., D.F., A.E., D.G.) and Trauma Unit (M.M.), Rambam Medical Center, Haifa, Israel; and the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (A.E., D.G.).

Address correspondence to Diana Gaitini, MD, Unit of Ultrasound, Department of Medical Imaging, Rambam Medical Center, PO Box 9602, Haifa 31906, Israel. E-mail: d_gaitini{at}rambam.health.gov.il

Objective. The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict. Methods. The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records. Results. Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P < .05). Conclusions. In a setting of a war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.

Key Words: focused assessment with sonography for trauma • multiple-casualty incidents • triage

Abbreviations: CT, computed tomography • FAST, focused assessment with sonography for trauma • FN, false-negative • FP, false-positive • ISS, Injury Severity Score • MCI, multiple-casualty incident • NPV, negative predictive value • PPV, positive predictive value • TN, true-negative • TP, true-positive




This article has been cited by other articles:


Home page
 TraumaHome page
M. Christie-Large, D. Michaelides, and S. James
Focused assessment with sonography for trauma: the FAST scan
Trauma, April 1, 2008; 10(2): 93 - 101.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Institute of Ultrasound in Medicine.