@article{ref1,
title="Early FAST examinations during resuscitation may compromise trauma outcomes",
journal="American surgeon",
year="2018",
author="Kleinman, John and Inaba, Kenji and Pott, Emily and Matsushima, Kazuhide and Demetriades, Demetrios and Strumwasser, Aaron",
volume="84",
number="10",
pages="1705-1709",
abstract="Focused assessment with Sonography for trauma (FAST) examination is essential to trauma triage. We sought to determine whether FASTs completed early in sequencing portend worse outcomes. A two-year review (2014-2015) of all trauma activations at our Level I trauma center was performed. Patients were matched at baseline and FAST times were compared. Outcomes included resuscitation time (RESUS-h), ventilation days (d), hospital length of stay (HLOS-d), ICU length of stay (LOS-d), survival (%), nosocomial infection rate (%), and venous thromboembolism complication rate (%). ED interventions included transfusions, crystalloid, antibiotics, central line placement, intubation, thoracostomy, thoracotomy, pelvic X-ray, and binder. One thousand, three hundred and twelve patients were included for analysis (mean age = 38 ± 19 years, mean Injury Severity Score = 12 ± 11, 21% penetrating). Compared with FASTs completed after the primary survey, early FASTs led to significantly more ventilation days (<i>P</i> < 0.01), longer ICU length of stay (<i>P</i> < 0.01), and a greater incidence of nosocomial infections (<i>P</i> = 0.03). In the ED, early FASTs led to significantly more intubations (<i>P</i> < 0.01) and transfusions (<i>P</i> < 0.01) compared with late FASTs. FASTs completed before primary survey portend worse outcomes, with more ED interventions and equivocal results. FAST as a true adjunct to primary survey is recommended.<p /> <p>Language: en</p>",
language="en",
issn="0003-1348",
doi="",
url="http://dx.doi.org/"
}