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E-Fast exams in low -moderate risk trauma patients
rn-md@sbcglobal.net
Posted: Tuesday, November 8, 2016
Joined: 6/6/2011
Posts: 1


All:

Does anyone have an expectation on which patients will get e-fast exams and within what time?  I'm not talking about trauma activations. I'm looking more at stable patients with low impact injuries, ground level fall, elderly patients with chest and/or abd pain etc.

If so is it a written policy or just an expectation.


Thanks,


Mark


Mark Kerschner, MD FACEP

Co-Medical Director and Section Chief

Emergency Medicine

Bronson Methodist Hospital

Kalamazoo, Michigan


flanniganmatt@yahoo.com
Posted: Saturday, January 28, 2017
Joined: 2/9/2011
Posts: 3


Hi Mark,


I'll send you a pdf of a recent article posted on the list serve by Chip S that addresses this very issue.  DOI 10.1186/s13049-016-0342-0


"Should we perform a FAST exam in hemodynamically stable patients presenting after blunt abdominal injury: a retrospective cohort study"  Scandinavian Journal of Trauma


My perspective is that this is an inexpensive screening tool that predicts injuries, particularly for transient responders, so you're able to anticipate bad things happening.  For stable patients, with low pretest probability for injuries, it offers an ability to "slow down" the code to do a proper history and exam, consider shared decision making and serial monitoring before defaulting to a pan scan.  Like any test, it has the opportunity to influence pretest probability up or down.


Matt Flannigan, DO, RDMS

Fellowship Director

Spectrum Health / Emergency Care Specialists Ultrasound Fellowship

Grand Rapids, MI


 
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