Oliveira Luan Geraldo Ocaña, Tagliari Debora, Becker Mariana Juliato, Adame Thiago, Cruvinel Neto José, Spencer Netto Fernando Antônio Campelo
- Universidade Estadual do Oeste do Paraná, Serviço de Cirurgia Geral, Cascavel, PR, Brasil.
Rev Col Bras Cir. 2018 Feb 19;45(1):e1556. doi: 10.1590/0100-6991e-20181556.
to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma) for emergency physicians in the primary evaluation of abdominal trauma.
a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT). FAST results started to be collected two months after the course. These were compared with a composite score of complementary exams and surgical findings. Information was stored in a Microsoft Excel program database and submitted to statistical analysis.
FAST was performed in 120 patients. In the study, 38.4% of the assessed patients had a shock index ≥0.9. The composite score detected 40 patients with free peritoneal fluid, whereas FAST detected 27 cases. The method sensitivity was 67.5%, specificity was 98.7%, the positive predictive value was 96.4%, the negative predictive value was 85.39% and accuracy was 88%. All those with a positive FAST had a shock index ≥0.9. Fifteen patients with positive FAST and signs of instability were immediately submitted to surgery.
the basic training of emergency physicians in FAST showed efficiency and usefulness in abdominal trauma assessment. Due to its low cost and easy implementation, this modality should be considered as a screening strategy for patients with abdominal trauma in health systems.
验证创伤基础超声培训（FAST - 创伤重点超声评估）对急诊医生在腹部创伤初步评估中的有效性和实用性。
于2015年至2017年开展了一项纵向观察性研究，对来自巴拉那西部大学医院的11名急诊医生进行了急诊与创伤超声培训（USET® - SBAIT）。课程结束两个月后开始收集FAST结果。将这些结果与辅助检查和手术发现的综合评分进行比较。信息存储在Microsoft Excel程序数据库中并进行统计分析。
对120例患者进行了FAST检查。在该研究中，38.4%的评估患者休克指数≥0.9。综合评分检测出40例有腹腔游离液体的患者，而FAST检测出27例。该方法的敏感性为67.5%，特异性为98.7%，阳性预测值为96.4%，阴性预测值为85.39%，准确性为88%。所有FAST结果为阳性的患者休克指数均≥0.9。15例FAST结果为阳性且有不稳定体征的患者立即接受了手术。
急诊医生在FAST方面的基础培训在腹部创伤评估中显示出有效性和实用性。由于其成本低且易于实施，这种方式应被视为卫生系统中腹部创伤患者的筛查策略。
