INTRODUCTION: The Focused Assessment with Sonography in @entity130 examination (FAST) is currently taught and recommended in the ATLS(  ), often as an addendum to the primary survey for @entity1 with blunt @entity1661 . Although it is non-invasive and rapidly performed at bedside, the utility of FAST in blunt @entity1661 has been questioned. We designed this study to examine our hypothesis that FAST is not an efficacious screening tool for identifying intra- @entity3511 . METHODS: We performed a retrospective chart review of all @entity1 with confirmatory diagnosis of blunt @entity3511 with CT and/or laparotomy for a period of 1.5 years (from 7/2009 to 11/2010). FAST was performed by ED residents and considered positive when free intra-abdominal fluid was visualized. Abdominal CT, or exploratory laparotomy findings were used as confirmation of intra-abdominal injury. RESULTS: A total of 1671 blunt @entity130 @entity1 were admitted to and evaluated in the Emergency Department during a 1   year period and 146 @entity1 were confirmed intra- @entity3511 by CT and/or laparotomy. Intraoperative findings include @entity99 , spleen, kidneys, and bowels. In 114 hemodynamically stable @entity1 , FAST was positive in 25 @entity1 , with a sensitivity of 22%. In 32 hemodynamically unstable @entity1 , FAST was positive in 9 @entity1 , with a sensitivity of 28%. A free peritoneal fluid and @entity130 are associated with a positive FAST on univariate analysis, and are the independent predictors for a positive FAST on multiple logistic regression. CONCLUSION: FAST has a very low sensitivity in detecting blunt @entity130 . In hemodynamically stable @entity1 , a negative FAST without a CT may result in missed intra- @entity3511 . In hemodynamically unstable blunt @entity130 @entity1 , with clear physical findings on examination, the decision for exploratory laparotomy should not be distracted by a negative FAST.

Do we really rely on fast for decision-making in the management of blunt XXXX ?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1661 :: ('MESH:D000008', 'Disease') :: ['abdominal trauma'] @entity3511 :: ('MESH:D000007', 'Disease') :: ['abdominal injuries'] @entity99 :: ('MESH:D056486', 'Disease') :: ['injuries to the liver'] @entity130 :: ('MESH:D014947', 'Disease') :: ['splenic injury', 'intraabdominal injury', 'Trauma', 'trauma']
@entity1661 :: (MESH:D000008,Disease) :: ['abdominal trauma']
