The role of focused abdominal sonography for trauma (FAST) in pediatric trauma evaluation
Section snippets
FAST training
Six surgeons were trained and evaluated over an average of 16 months prior to initiation of the study. Training included technical instruction on use of the US machine, and viewing of an instructional video on FAST. A didactic session was held to teach the principles and physics of US and FAST, as well as provide hands-on training in the approach to the FAST exam. Proctored exams occurred in the clinic setting, as well as during trauma resuscitations. Proctoring and further training were
Results
During the study period, 676 children required activation of the trauma team for evaluation of traumatic injury. Of these, 140 presented with prior abdominal imaging at an outside facility, and were excluded for analysis. Of the remaining 536 cases, 183 had potential abdominal trauma, as indicated by planned use of abdominal CT during initial evaluation, and not having open or penetrating abdominal wound. Out of these 183 cases considered eligible for enrollment into the study, ultrasound was
Discussion
The interest in emergency US in pediatric EDs has increased dramatically in recent history. A survey of children's hospitals and pediatric emergency medicine training programs revealed that 96% of responders reported having a dedicated US machine in the ED but only 27% reported having a program for the clinical use of US. It is concerning that of those who use US only 52% of the institutions had established credentialing criteria to grant US privileges [13]. The American College of Surgeons
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