Ngwelezane Hospital Emergency Department, KwaZulu-Natal.
S Afr Med J. 2010 Jan 29;100(2):105-8. doi: 10.7196/samj.3821.
To assess the utility of an existing ultrasound machine for the purposes of focused assessment sonography in trauma (FAST) scanning in a developing world emergency department (ED).
Prospective study undertaken over a 12-month period. Trauma patients attending the ED were FAST scanned by one of three trained emergency medicine doctors.
The ED at a government hospital in rural KwaZulu-Natal (KZN), the referral centre for 22 peripheral hospitals.
All patients presenting to the ED who had sustained abdominal or thoracic trauma.
Scans were recorded as positive or negative for free intra-abdominal or pericardial fluid. All results were confirmed by computed tomography, laparotomy or a second trained ED ultrasonographer, followed by a period of clinical observation.
72 FAST scans were included, 52 for blunt trauma and 20 for penetrating trauma. Of the 72 scans, 15 (20.8%) were positive. FAST scanning had 100% specificity and overall sensitivity of 71.4%. When considering blunt trauma alone the sensitivity improved to 81.3%, while in penetrating trauma it was much poorer (62.5%).
We propose a valuable role for FAST scanning in all peripheral hospitals for the assessment of patients sustaining blunt trauma. In rural areas with limited resources FAST scans may assist in the appropriate timely transfer of trauma patients for further imaging or definitive surgical intervention.
评估在发展中国家的急诊科中，现有超声机在进行创伤重点评估超声检查（FAST）中的应用价值。
在 12 个月的时间内进行的前瞻性研究。三位经过培训的急诊医生对急诊科的创伤患者进行 FAST 扫描。
夸祖鲁-纳塔尔省（KZN）农村地区的政府医院急诊科，是 22 家外围医院的转诊中心。
所有因腹部或胸部创伤而就诊于急诊科的患者。
扫描结果记录为是否存在游离腹腔或心包积液。所有结果均通过计算机断层扫描、剖腹术或第二位经过培训的急诊科超声医师进行确认，然后进行一段时间的临床观察。
共纳入 72 例 FAST 扫描，其中 52 例为钝性创伤，20 例为穿透性创伤。在 72 例扫描中，有 15 例（20.8%）为阳性。FAST 扫描具有 100%的特异性和 71.4%的总体敏感性。仅考虑钝性创伤时，敏感性提高到 81.3%，而穿透性创伤时则较低（62.5%）。
我们建议在所有外围医院中，FAST 扫描可用于评估钝性创伤患者。在资源有限的农村地区，FAST 扫描可能有助于及时将创伤患者转移到合适的地方进行进一步的影像学检查或确定性手术干预。
