FAST Underperforms in Patients with Hemodynamic Instability

FAST when performed by radiology residents had low sensitivity for detecting hemoperitoneum in hemodynamically unstable trauma patients.

Advantages of the Focused Assessment with Sonography for Trauma (FAST) include bedside performance, lack of ionizing radiation, ability to perform serial examinations, and 70% to 90% sensitivity overall for detecting hemoperitoneum. However, the sensitivity of FAST in blunt trauma patients with pelvic fracture seems to be lower (JW Emerg Med Feb 9 2007) and its accuracy in patients with potential hemodynamic instability is uncertain (JW Emerg Med Sep 25 2009). In a prospective observational study, researchers at a major trauma center in Norway assessed the accuracy of FAST for detecting hemoperitoneum in 204 patients who presented with potential hemodynamic instability (systolic blood pressure ≤90 mm Hg, pulse rate ≥120, or base deficit ≥8)…

Reviewing Author

John A. Marx, MD, FAAEM