TITLE:
Focused Assessment with Sonography in Trauma (FAST) Scans Are Not Sufficiently Sensitive to Rule out Significant Injury in Pediatric Trauma Patients
AUTHORS:
Clare Skerritt, Saira Haque, Erica Makin
KEYWORDS:
Blunt Trauma, Ultrasound, FAST
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.4 No.3,
September
19,
2014
ABSTRACT: Aim: To assess the
sensitivity and specificity of FAST scans in pediatric trauma in a dedicated
pediatric trauma centre. Method: A 3-year (2008-2011) analysis of prospectively
collected datalooking at the
results of FAST scans compared to Computed Tomography (CT) or laparotomy
findings. Results: There were 482 pediatric trauma calls of which 166 patients
had suspected intra-abdominal injury. 163 patients underwent CT scans of which
89 (55%) had FAST scans prior to CT. 3 patients had FAST scans without CT; 1
patient went straight to theatre (positive FAST) and 2 patients died in the
department before any further imaging. The sensitivity of FAST scans to detect
abdominal injury is 23% and the specificity is 97%. The injuries missed on FAST
scan were: liver lacerations (n = 3), splenic lacerations (n = 5), 1 combined
liver and kidney injury and 1 combined splenic injury and small bowel
perforation. Conclusions: FAST scans in trauma have a low sensitivity in
pediatric patients with the possibility of missing significant intra-abdominal
injury. They do not obviate the need for CT scan when clinical suspicion is
high.