A prospective trial of surgical resident performed focused abdominal sonography for trauma (FAST): an easy training method

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Introduction

Ultrasound is a quick, easy tool for evaluating trauma patients. A focused abdominal sonogram for trauma (FAST) is a limited sonographic evaluation easily learned by those with minimal experience. Our study attempts to prove that surgical residents of all postgraduate levels can be trained with a short didactic session followed by hands-on experience, studying patients with known intra-abdominal fluid. With this method, surgical residents can be quickly and cost-effectively taught to perform FAST examinations with proficiency rates matching those of the literature .

Materials and methods

In this prospective randomized trial, thirteen surgical residents were trained to perform FAST scans. Residents attended a 3-hour didactic course and then performed three normal FAST scans followed by four scans on patients with known intra-abdominal fluid. Lastly, trauma patients over a six-month period were studied. FAST results were compared to CT, DPL, or serial examination results. Statistical analysis was performed.

Results

In 93.8% of patients no fluid was detected. There was one false positive and one false negative exam. The sensitivity and specificity were 80% and 99%, respectively. Positive and negative predictive values were 80% and 99%, respectively. A kappa statistic of 0.79 was calculated indicating a substantial amount of agreement between the FAST scan group and the CT/DPL/serial exam group.

Discussion

Sonography guidelines for the training of surgical residents are needed. By maximizing positive examinations, the number of required proctored examinations can be lowered and the learning curve shortened. In a short time, surgical residents can learn to perform the FAST scan with proficiency rates matching that of the literature.

Conclusion

By training on patients with known intra-abdominal fluid, in a short time, surgical residents can learn the FAST scan. With our method, resident proficiency can match that of more experienced personnel.