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Senior general surgery residents can be trained to perform focused assessment with sonography for trauma patients accurately

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Abstract

Purposes

Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments.

Methods

This was a retrospective study in the emergency department (ED) of our hospital performed from January 2011 to September 2013. Patients were included if they (1) had undergone a FAST examination performed by qualified residents and (2) had received subsequent formal radiographic or surgical evaluations. The results were compared against subsequent surgical findings or formal Department of Radiology reference standards.

Results

Among the 438 patients enrolled, false-negative results were obtained in 8 and false-positive results in 5. Only one patient was missed and required laparotomy to repair a small intestine perforation. The sensitivity and specificity were 87 and 99%, respectively; the accuracy was 97%.

Conclusions

Senior general surgery residents can be trained to perform accurate FAST examinations on trauma patients.

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Authors and Affiliations

  1. Division of Traumatic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Taipei, 114, Taiwan, ROC

    Sheng-Der Hsu & Cheng-Jueng Chen

  2. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

    Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan & Jyh-Cherng Yu

Authors
  1. Sheng-Der Hsu
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  2. Cheng-Jueng Chen
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  4. Jyh-Cherng Yu
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Contributions

SDH contributed to this study in its conception, design, analysis of the data, and the drafting and revision of the manuscript. CJC contributed to the acquisition and analysis of the data and drafting and revising of the manuscript. JCY and DCC contributed to the conception and design of the study as well as the acquisition and analysis of the data and drafting and revising of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sheng-Der Hsu.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors report no conflicts of interest.

Ethics approval

The study methods were reviewed and approved by the Institutional Review Board II of the Tri-Service General Hospital, National Defense Medical Center.

Data sharing statement

No additional data are available.

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Hsu, SD., Chen, CJ., Chan, DC. et al. Senior general surgery residents can be trained to perform focused assessment with sonography for trauma patients accurately. Surg Today 47, 1443–1449 (2017). https://doi.org/10.1007/s00595-017-1535-5

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  • DOI: https://doi.org/10.1007/s00595-017-1535-5

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