Document Detail


FAST ultrasound as an adjunct to triage using the START mass casualty triage system: a preliminary descriptive system.
MedLine Citation:
PMID:  16418098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether the FAST examination might be a useful adjunct to simple triage and rapid treatment (START) in the secondary triage of mass-casualty victims already classified as delayed (Yellow). METHODS: A retrospective chart review was conducted of all adult trauma patients evaluated by the trauma surgery service at a level 1 trauma center between January 1 and December 31, 2003. Patients were retrospectively triaged to one of three START categories: immediate (Red), delayed (Yellow), or expectant (Black). The FAST results were obtained from the medical records. RESULTS: FAST results were available for 359 patients, of which 27 were classified as positive. Twenty (6.9%) of 286 patients retrospectively triaged as delayed (Yellow) had positive FAST studies. Of these, six underwent operative intervention within 24 hours of arrival. A total of 232 patients had both FAST and computed tomography (CT) studies performed, of which 19 FAST studies were inconclusive. In the remaining 213 patients, six of 27 had falsely positive studies, while 24 of 186 had falsely negative studies. CONCLUSIONS: Portable ultrasound technology might have identified 20 delayed (Yellow) patients with evidence of hemoperitoneum, thereby expediting evacuation to definitive care. However, only 30% of these patients subsequently underwent an operative intervention within 24 hours of arrival. Both over- and undertriage were significant problems. As such, the current study does not support the routine use of FAST ultrasound as a secondary triage tool.
Authors:
Matthew D Sztajnkrycer; Amado Alejandro Baez; Anuradha Luke
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  10     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2006 Jan-Mar
Date Detail:
Created Date:  2006-01-18     Completed Date:  2006-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  96-102     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA. Sztajnkrycer.Matthew@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Disaster Planning
Emergency Medical Services / methods*
Female
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Retrospective Studies
Trauma Centers / statistics & numerical data
Triage / methods*
Ultrasonography / methods
United States
Wounds and Injuries / classification*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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