Is FAST  Too FAST?

2020 ◽  
pp. 75-80
Author(s):  
Laurie Malia ◽  
Joni E. Rabiner
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Point Of Care ◽  
Pediatric Trauma ◽  
Abdominal Injury ◽  
Reliable Information ◽  
Highly Sensitive ◽  
Fast Exam

Blunt abdominal trauma is common in pediatric trauma. This chapter discusses a child who presents to the emergency department with left upper quadrant pain after being struck by a motor vehicle. The point-of-care focused assessment with sonography for trauma (FAST) examination provides quick, reliable information on bleeding into the peritoneal, pericardial, and pleural spaces in the setting of trauma. The FAST exam is highly sensitive for identification of hemoperitoneum but is less accurate for ruling out hemoperitoneum and intra-abdominal injury. Discussion of the trauma evaluation and utility of the FAST examination in the context of pediatric blunt abdominal trauma is presented.

scholarly journals Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

CJEM ◽  
2012 ◽  
Vol 14 (01) ◽  
pp. 14-19 ◽  
Author(s):  
Robin Cardamore ◽  
Joe Nemeth ◽  
Christine Meyers
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Positive Impact ◽  
Pediatric Trauma ◽  
Great Majority ◽  
Pediatric Emergency ◽  
Perceived Barriers ◽  
Emergency Physicians ◽  
The Future

ABSTRACT Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

scholarly journals Comparison of Blunt Abdominal Trauma Scoring System (BATSS) versus FAST in assessment of Blunt Trauma Abdomen

2021 ◽  
Vol 14 (4) ◽  
pp. 2183-2189
Author(s):  
T S Subbiah ◽  
Athira Gopinathan ◽  
Balamurugan Ramachandran
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Scoring System ◽  
Point Of Care ◽  
Abdominal Injury ◽  
World Health ◽  
World Population ◽  
Emergency Rooms ◽  
The World ◽  
Trauma Scoring

Trauma is the second largest cause of disease worldwide accounting for more than 16 % of global burden 1. By the next decade, the World Health Organization (WHO) estimates that trauma will be the leading cause of Years of Potential Life Lost (YPLL) amongst the world population. With advancement in infrastructure and economic prosperity, accidental trauma due to vehicular accidents has become more commonplace. A majority of victims of motor vehicular accidents present with Blunt abdominal trauma, which due to the complexity in diagnosis and management, presents with significant morbidity and mortality2. Introduced in the 1970s in Europe, point of care Ultrasonographic examination of the abdomen in trauma called as FAST (Focussed Assessment with Sonography for Trauma) has become a routine in emergency rooms worldwide 3. The Blunt Abdominal Trauma scoring system was developed to better diagnose intra-abdominal injury after blunt abdominal trauma 4. This study is aimed in comparing the findings of FAST and BATSS in predicting intra-abdominal injury accurately.

scholarly journals A retrospective study of blunt trauma abdomen in a tertiary center in central India: evaluation, management and outcome

2020 ◽  
Vol 7 (8) ◽  
pp. 2696
Author(s):  
Sanjay Sisodiya ◽  
Prateek Malpani
Keyword(s):  
Retrospective Study ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Early Recognition ◽  
Imaging Techniques ◽  
Abdominal Injury ◽  
High Morbidity ◽  
Tertiary Center

Background: Blunt abdominal trauma is fairly common emergency and it is one of the important components of polytrauma. It requires high degree of suspicion, investigation and management. Inspite of improved imaging techniques leading to early recognition it is still associated with high morbidity and mortality. Trauma is the leading cause of blunt abdominal injury. This aim of the study was to find etiology, early diagnosis and management of patients with blunt abdominal trauma.Methods: This a retrospective study conducted in Gandhi medical college, Bhopal in which 90 cases of blunt abdominal trauma presented to emergency and outpatient department were included in the study duration of January 2019 to December 2019.Results: Motor vehicle accident was the most common mode of injury. Liver being the most common visceral organ injured while the most common surgery performed was the repair or resection and anastomosis of hollow viscous perforation. Rib fracture was the most common extra abdominal injury seen in 17.7% cases. Mortality rate was 5.5%. Most of the liver, spleen and renal injuries can be managed non-operatively whereas hollow viscous injury needs laparotomy.Conclusions: The result of present study is similar to other studies. Rapid diagnosis, early and timely referral, adequate and trained staff, close and careful monitoring, early wise and skilled decision to go for operative or non-operative management can help save many lives.

scholarly journals Blunt Abdominal Trauma Patients Are at Very Low Risk for Intra-Abdominal Injury after Emergency Department Observation

2011 ◽  
Vol 12 (4) ◽  
pp. 496-504 ◽  
Author(s):  
John Kendall ◽  
Andrew Kestler ◽  
Kurt Whitaker ◽  
Mette-Magarethe Adkisson ◽  
Jason Haukoos
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Low Risk ◽  
Abdominal Injury ◽  
Trauma Patients

scholarly journals Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Agron Dogjani ◽  
Kastriot Haxhirexha ◽  
Edvin Selmani ◽  
Hysni Bendo ◽  
Amarildo Blloshmi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Age ◽  
Predictive Tool ◽  
Trauma Score

Background: Trauma is the leading cause of morbidity and mortality in pediatric age. Abdominal trauma is the third most frequent cause of trauma injuries in children. The purpose of our study is to discuss BATp epidemiology and its relationship with polytrauma, , to recognize and describe the mechanisms of blunt abdominal trauma in pediatric age and to identify the signs and symptoms that associate it. Material and methods: In this retrospective study we reviewed all patients with blunt abdominal trauma in pediatric age who presented in Emergency Department at the University Hospital of Trauma in Tirana, Albania in the period between December 1-st 2017 and June 24-th 2018. The sample in the study was taken randomly. The Injury Severity Score, Revised Trauma Score were used as important points to evaluate gravity of injuries, and method of treatment. The data was introduced in absolute and percentage values and Kendal's tau b correlation coefficient and the regression analysis was used to analyze and to find out any association among the dependent versus independent variable. The type of study is case control with two components; descriptive and analytical. Results: In the time period that we studied, about 25200 patients were presented in Emergency department and 6.68% of these cases were hospitalized. Most frequent causes were motor vehicle accidents (35.4%) and abdominal trauma comprised 25.8% of cases, whereas in children it comprised 13.7% of total pediatric trauma. We have found correlation between the injury severity score and complications rate (r = 0.254, n = 49, p <0.001), and injury severity score with length of hospital stay (r = 0279, n = 49, p <0.001). Conclusions: Blunt Abdominal Trauma in pediatric age is a serious threat to the health of the children. Their treatment should be carried out not only in tertiary trauma centers but in every regional hospital. The trauma score is very valuable to determine the gravity of the injury, method of treatment and is a predictive tool in trauma outcomes.

scholarly journals Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2350
Author(s):  
Puran . ◽  
Narendra Kumar Kardam
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Abdominal Trauma ◽  
Imaging Modality ◽  
Abdominal Injury ◽  
Male Predominance ◽  
Ct Findings ◽  
Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed   tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

scholarly journals An experience with blunt abdominal trauma: evaluation, management and outcome

2014 ◽  
Vol 4 (2) ◽  
Author(s):  
Nikhil Mehta ◽  
Sudarshan Babu ◽  
Kumar Venugopal
Keyword(s):  
Early Diagnosis ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
World Health ◽  
Common Mechanism ◽  
World Population ◽  
Diagnosis And Management ◽  
Time Of Presentation

Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of <em>years of productive life</em> <em>lost</em> for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives.

Pediatric Thoraco-Abdominal Trauma

2020 ◽  
pp. 405-409
Author(s):  
Christopher S. Amato
Keyword(s):  
Abdominal Trauma ◽  
Thoracic Trauma ◽  
Pediatric Trauma ◽  
Medical Personnel ◽  
Abdominal Injury ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Common Cause ◽  
Thoracic And Abdominal ◽  
Trauma Deaths

In children, injury is the most common cause of death. Thoracic and abdominal trauma are both associated with high morbidity and mortality, and they warrant a thorough evaluation. Abdominal trauma occurs in 25% of children with major trauma and is responsible for 9% of all trauma deaths. Because it can delay care, lack of recognition of intra-abdominal injury increases morbidity and mortality. Thoracic trauma comprises only 4–6% of pediatric trauma but is related to 14% of pediatric trauma-related deaths and is the second most common cause of mortality in pediatric trauma. This chapter discusses the keys to the evaluation of the pediatric trauma patient with thoraco-abdominal injury, including the evidence-based approach and algorithms to be utilized by medical personnel.

scholarly journals Traumatic gastric rupture following blunt abdominal trauma: a case report about an atypical modality of presentation

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Dario Giambelluca ◽  
Dario Picone ◽  
Natalino Carmelo Pennisi ◽  
Bruno Luciani ◽  
Giuseppe Lo Re ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Rare Presentation ◽  
Operative Morbidity ◽  
Mortality And Morbidity ◽  
Vehicle Accident ◽  
Gastric Rupture ◽  
History Of

Gastric rupture following blunt abdominal trauma is a rare presentation with a reported incidence of 0.02-1.7% in current literature. Traumatic gastric rupture is usually associated with other visceral injuries, such as splenic lesions and fractures. Prompt diagnosis and early intervention reduce mortality and morbidity. History of a recent meal has been implicated in traumatic gastric rupture. 2 We report a case of blunt abdominal trauma with an isolated gastric rupture after a motor vehicle accident, managed successfully without any post-operative morbidity and mortality.

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