From the Clinical Instructor and Pediatric Emergency Medicine Fellow.
Assistant Professor of Pediatrics and Emergency Medicine, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Pediatr Emerg Care. 2021 Dec 1;37(12):624-629. doi: 10.1097/PEC.0000000000002573.
Blunt abdominal trauma (BAT) accounts for most trauma in children. Although the focused assessment with sonography in trauma (FAST) is considered standard of care in the evaluation of adults with traumatic injuries, there is limited evidence to support its use as an isolated evaluation tool for intra-abdominal injury as a result of BAT in children. Although a positive FAST examination could obviate the need for a computed tomography scan before OR evaluation in a hemodynamically unstable patient, a negative FAST examination cannot exclude intra-abdominal injury as a result of BAT in isolation. In this article, we review the evaluation of BAT in children, describe the evaluation for free intraperitoneal fluid and pericardial fluid using the FAST examination, and discuss the limitations of the FAST examination in pediatric patients.
钝性腹部创伤（BAT）是儿童创伤中最常见的类型。虽然超声检查在创伤中的重点评估（FAST）被认为是成人创伤评估的标准护理方法，但支持将其作为 BAT 导致儿童腹腔损伤的孤立评估工具的证据有限。虽然在血流动力学不稳定的患者中，阳性 FAST 检查可以排除在 OR 评估前进行 CT 扫描的需要，但阴性 FAST 检查不能单独排除 BAT 导致的腹腔内损伤。在本文中，我们回顾了儿童 BAT 的评估方法，描述了使用 FAST 检查评估游离腹腔积液和心包积液，并讨论了 FAST 检查在儿科患者中的局限性。
