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FAST scan in STABLE BLUNT TRAUMA patients

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My presentation from the SWAN Trauma Conference (2017).
"FAST scan in stable blunt trauma patients?".

Published in: Health & Medicine
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FAST scan in STABLE BLUNT TRAUMA patients

  1. 1. FAST Scan in Stable Blunt Trauma Patients? Dr CHRIS PARTYKA Emergency Physician - LIVERPOOL HOSPITAL Prehospital & Retrieval Specialist - SYDNEY HEMS
  2. 2. NO !! He does NOT need a CT scan He must go to directly to theatre…
  3. 3. WHAT IS STABLE ?
  4. 4. IS IT STILL WORTHWHILE ?
  5. 5. 2105 scans Sn 43% Sp 99% Stable blunt trauma patients... Sn 41% Sp 99%
  6. 6. Stable blunt trauma patients…
  7. 7. IS IT STILL REALLY NEGATIVE ?
  8. 8. 421 patients 407 negatives 14 positives Sn 67% Sp 99% 2x OT, 3x IR, 1x died in ED
  9. 9. 421 patients 407 negatives 14 positives Sn 67% Sp 99% Predicts ‘badness’ +LR 34 … more reliable than ISS
  10. 10. 3907 normotensive patients 3584 negatives 323 positives Sn 85% Sp 96% 59% required laparotomy
  11. 11. 3907 normotensive patients 3584 negatives 323 positives Sn 85% Sp 96% 59% required laparotomy
  12. 12. IS IT STILL WORTHWHILE ?
  13. 13. THE PLURAL OF ANECDOTE IS NOT DATA
  14. 14. HIGH SPEED CAR ROLLOVER 88 MINUTE FLIGHT
  15. 15. PRIMARY SURVEY Protected. Dried blood ?haemoptysis RR 32, SaO2 94% (O2). Right crackles & ↓AE. Warm. No ext haem. P 120, SBP 140. ?L femur # GCS 15. PEARL. Moving all 4. Afebrile. Left leg short + ext rotated A. B. C. D. E.
  16. 16. OUTCOME RIGHT PULMONARY CONTUSION. NO PTX. MULTIPLE RIB #s LEFT NOF# Intubated for NOF repair, extubated same day No chest drain required during admission. 1. 2. 3.
  17. 17. FAST Scan in Stable Blunt Trauma Patients? YES !!!
  18. 18. TRIAGE COMMUNICATION THE CANARY
  19. 19. ANY QUESTIONS ? thebluntdissection.org/SWAN

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