Suzannah Dewhurst1,2, Matthew Binks1,2, Stacey Casley1, Steve Wood1,2
1. Wagga Wagga Base Hospital
2. University of New South Wales
Aim
Regular reviews of trauma services are an important mechanism of performance improvement, to ensure ongoing high standards and focus on patient safety. Rural areas see considerable amounts of trauma, accounting for 28.1% of all major trauma incidents. The Focused Assessment with Sonography for Trauma (FAST) scan is an accessible tool that is available in regional areas and used to support rapid decision making as an adjunct to the primary survey.
Method/Description
An audit of Trauma Attends at Wagga Wagga Base Hospital occurred between July 2020 and June 2021. FAST scan results were reviewed and compared to the CT or laparotomy findings. The documentation of scans and outcomes of incomplete scans was also reviewed. The results were then compared to focused assessments on FAST scans throughout Australia.
Results
Of the documented 27 trauma attends in WWBH, 20 underwent a FAST scan. Of these 20, 1 scan did not match with the laparotomy findings of haemoperitoneum, demonstrating a 95% sensitivity of scanning. Notably, 3 scans were incomplete, one of which had significant intraabdominal bleeding intraoperatively. Of the 5 positive FAST scans, 2 patients went straight to the operating theatre without CT scanning.
Consclusions
The WWBH emergency department (ED) FAST scans demonstrated a high sensitivity of results. A secondary outcome of the study identified that documentation of the FAST scan was poor, and that incomplete scans had significant impact on time management in the trauma setting.