FAST ULTRASOUND

A BASIC TOOL TO EVALUATE THE BLUNT ABDOMINAL TRAUMA PATIENT AND HELP TO DECISION MAKING FOR EMERGENCY SURGERY

Abstract

Objective: Fast ultrasound is a basic tool to evaluate the blunt abdominal trauma
patient and help to decision making for emergency surgery. Study design: Observational study.
Place and duration of study: The King Fahad Hospital Madina Munawara, over a period
between 2010 and 2011. Methodology: This study consisted of 765 patients came in Emergency
department The King Fahad Hospital Madina Munawara Level II, or Regional Resource Trauma
Center Saudi Arabia. Detailed History was taken from all the patients with special regard to bland
abdominal trauma. All patients were brought to a trauma resuscitation area where a trauma team
conducted a primary survey, after an airway and adequate oxygenation/ventilation were
established. The FAST examinations were performed using 4 windows: subxiphoid, right upper
quadrant, left upper quadrant, and suprapubic. The critical areas for intra-abdominal bleeding
were the hepatorenal space (Morrison’s pouch), the spleno-renal space, and the pelvic pouch of
Douglas. The FAST examinations were interpreted on the spot and results Recorded. Results
were prepared with help of tables and graphs. Data was analyzed through SPSS software.
Results: 73 out of 765 patients who underwent FAST ultrasound in the Emergency Room. 40
(54.79%) cases were road traffic accident (RTA) injuries followed by injury due to fall were in
33(45.20%) cases. Findings are fast ultrasound observed 49 out of 73 patients (67.12%) were
considered positive FAST who had fluid (blood) in the peritoneal cavity and these patients shift to
Operative Room for surgery. While 24(32.87%) patients with no evidence of intraperitoneal fluid
were considered negative for FAST and these patient underwent CT scans for evidence of solid
organ injury(Chart No.2). 5 out of 24 cases of solid visceral trauma found on CT scan abdomen,
but had not been detected by FAST then shift to operative room after resuscitation. Conclusions:
We conclude that FAST ultrasound is very helpful to assessment of blunt abdominal trauma and
to detect intraabdominal fluid. Fast ultrasound can help in the quick decision for surgical
intervention within minutes of a patient's arrival at emergency department.