E-FAST AS A PRIMARY SURVEY ADJUNCT IN TRAUMA PATIENTS: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/8mxnjc66Keywords:
Abdomen, Emergency Medicine, Hemoperitoneum, Pneumothorax, Point-of-Care Ultrasound, , Thoracic Injuries, TraumaAbstract
Background: Trauma remains a leading cause of morbidity and mortality worldwide, necessitating rapid and accurate diagnostic tools during the initial assessment. Conventional imaging methods such as chest and pelvic radiographs are time-consuming and resource-dependent. The extended Focused Assessment with Sonography for Trauma (e-FAST) integrates abdominal, thoracic, and pericardial views, enabling early detection of life-threatening injuries like pneumothorax, haemothorax, and hemoperitoneum. Its role as a primary survey adjunct, however, remains under evaluation.
Objective: To determine the diagnostic accuracy and clinical utility of e-FAST as a primary adjunct in the initial trauma survey and its influence on emergency management decisions.
Methods: A prospective, cross-sectional study was conducted over 12 months (May 2024–May 2025) in the Emergency Department of a tertiary care teaching hospital. One hundred adult trauma patients were enrolled using convenience sampling. Each underwent a real-time e-FAST examination performed by trained emergency physicians during the primary survey. Findings were compared with computed tomography (CT) or intraoperative results as reference standards. Diagnostic performance indices, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated using IBM SPSS Statistics version 26.0. Associations were assessed using the Chi-square test with p < 0.05 considered significant.
Results: The mean age was 42.5 ± 16.8 years, with males comprising 75%. Road traffic accidents accounted for 60% of injuries. e-FAST demonstrated sensitivity and specificity of 94.4% and 98.8% for hemoperitoneum, 86.7% and 100% for hemothorax, and 91.7% and 99.9% for pneumothorax, respectively. The median scan time was 6 minutes (IQR: 4–8). In 15% of patients, e-FAST findings led to immediate surgical or procedural intervention (p < 0.001).
Conclusion: e-FAST is a highly accurate, rapid, and non-invasive diagnostic modality for the early identification of thoraco-abdominal injuries in trauma patients. It surpasses conventional radiographs in diagnostic efficiency and significantly influences critical management decisions. Routine integration of e-FAST into the primary trauma survey can optimize resuscitation workflows and improve patient outcomes.
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Copyright (c) 2025 Muhammad Ashfaq, Tamkeen Pervez, Amer Iqbal, Anees Ur Rehman, Riaz Ahmad, Maham Ali (Author)
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