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Published on February 16, 2017

Gundersen uses FAST test for blunt trauma

Patients suffering trauma may not have obvious warning signs of internal injury. Patients may also have injuries that are not apparent on the initial physical exam; can present with distracting injuries; and/or may be lacking adequate mental competence or medical history.

Jamie Prather

Jamie Prather, MD, Gundersen Surgery

That's why, explains surgeon Jamie Prather, MD, "Gundersen Emergency Services uses Focused Assessment with Sonography for Trauma or FAST as a diagnostic tool for patients who are hemodynamically unstable with suspicion of intra-abdominal injury. The primary FAST examination is used to evaluate the patient for blood and other fluids suggesting injury to the peritoneal and pericardial cavities."

"Traditionally, diagnostic peritoneal lavage (DPL) was used to determine if an unstable patient who sustained blunt abdominal trauma needed an exploratory laparotomy," Dr. Prather adds. "But this test was invasive and couldn't be used for serial assessments."

At Gundersen, FAST may be used for patients with blunt abdominal trauma and, when appropriate, for blunt and penetrating chest trauma.

The FAST examination:

  • Decreases the time to diagnose the presence and degree of hemoperitoneum in blunt abdominal trauma
  • Can be performed in hemodynamically unstable patients
  • Is noninvasive and requires no contrast material
  • Can be performed quickly and at the patient's bedside—no need to move patient
  • Can be repeated for serial examinations
  • Is safe for pregnant patients, children and other medically compromised patients
  • Eliminates the need for more invasive and costlier interventions in some cases
  • Can be performed simultaneously with other resuscitative care, providing vital information without the delays required of other imaging

"CT scan is still the best way to identify abdominal injuries in patients who are hemodynamically stable. The FAST exam is most useful in situations where the patient's condition is unstable," reports Dr. Prather.

Gundersen has used FAST for over a decade and Dr. Prather and some of her colleagues have received advanced training in the use of the FAST examination. Gundersen follows guidelines for FAST examination as outlined by the American College of Emergency Physicians (ACEP) and American College of Surgeons (ACS) as part of their Advanced Trauma Life Support (ATLS) protocol.

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