FAST Exam

 

VBMC TRAUMA CARE SERVICES GUIDELINE

TITLE: Focused Assessment with Sonography for Trauma (FAST) Quality Assurance

PURPOSE: Effective emergent evaluation of patients with blunt abdominal and/or multisystem injury is a fundamental requirement for quality trauma care. The methods used to determine, in a time sensitive fashion, the need for operative intervention has continued to evolve. The focused abdominal sonogram for trauma (FAST) has largely replaced diagnostic peritoneal lavage (DPL) as the method of choice to rapidly determine the source of significant intra-abdominal fluid, particularly in unstable patients

GUIDELINE:

FAST exam will be performed as an adjunct to the primary trauma survey in patients with suspected abdominal injuries secondary to a blunt mechanism.

FAST exam will be performed in the trauma bay of the emergency department at the bedside of the trauma patient. FAST exam may be performed by the surgical resident, ED attending or Trauma Attending, however, the decision to intervene based on the result of the FAST exam will be the responsibility of the Trauma Attending.

FAST images should be saved to local PACS imaging system for billing and quality assurance by comparing saved images to gold standard findings as defined by Trauma Services.

Upon completion of the FAST exam, one of the following criteria will be completed:

1.      Additional Imaging, including CT scan will be completed, or

2.      Management per trauma Attending, or

3.      Surgical Exploration will be undertaken

 

QUALITY ASSURANCE:

The trauma program will regularly monitor, review and provide loop closure (through Trauma Case Review, and annual provider OPPE) of the following:

1. Non-therapeutic laparotomy
2. Contradictory gold standard findings

3. Unexpected clinical outcome.