F.A.S.T Scans in pre hospital, Useful or not?

[aussiephil]

FAST scans are now standard in most hospitals for abdominal clearance post trauma.

For those who want to know more click here

With this in mind, & portable ultrasound becoming more affordable, should this item be considered for prehospital care to aid & assist in transport decisions?

[chbare]

FAST scans are now standard in most hospitals for abdominal clearance post trauma.

For those who want to know more click here

With this in mind, & portable ultrasound becoming more affordable, should this item be considered for prehospital care to aid & assist in transport decisions?

It takes a significant amount of education to identify normal anatomic structures such as Morrison's pouch, and then identify free fluid collections. In addition, the FAST exam does not give us good retroperitoneal information. Therefore, I am not sure field use of current FAST technology for trauma triage is a particularly worthwhile endeavor. Are there solid studies on this topic? I know Austin uses ultrasound technology; however, I am not aware of any large studies that show significant benefits to pre hospital FAST exams.

Take care,

chabre.

Edit to spell "of" properly.

Edited September 8, 2009 by chbare

[spenac]

Yes this should be added.

Here is a service with it in my area.

http://www.odessa-tx.gov/public/firedepartment/ultrasound.asp

http://www.odessa-tx.gov/public/firedepartment/ultrasound.asp

Edited September 9, 2009 by spenac

[VentMedic]

Yes this should be added.

Here is a service with it in my area.

http://www.odessa-tx.gov/public/firedepartment/ultrasound.asp

http://www.odessa-tx.gov/public/firedepartment/ultrasound.asp

Odessa? Isn't this the same department that is constantly begging for money to support their US program and sent some of their Paramedics to Paris for a conference after more begging for money from the citizens by telling them how it would improve their lives? If a department wants more gadgets, they need to work out the details of how to pay for them and continue to maintain them. I have not seen them publish their data in a reputable medical journal besides "JEMS". On the other hand, Germany and France a few studies but there is also distance/trauma center and training differences.

The US has it's place if it is truly needed to determine your destination but then that also depends on whether you are ruling in or ruling out. It would be tragic if some thought everything was find and took a bleeder to a little community hospital in the opposite direction. If you see a reason to use the US, you probably already suspect something and may not need the technology to confirm that. Thus, hospital emergency teams can also be activated by a thorough assessment and well give report to doctors at the ED who have come to trust your skills and knowledge.

If you are already transporting to a trauma center, they have emergency teams on standby. They may also do the same exam in the ED as few surgeons are going to cut based on a prehospital study. Thus, it is not going to change where the patient goes or what the hospital will do. Even if there was a negative finding with the US I would not likely change my destintation if the patient met trauma criteria or if the patient presented with symptoms such as dropping BP and abdominal rigidity. For this reason we decided not to carry the US after the intial trial. There were other pieces of equipment which are needed that could make a difference in the field.