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"No So FAST"

caesar ursic trauma-list@trauma.org
Thu, 3 Apr 2003 06:42:49 -0800 (PST)

> FAST was not designed to replace CT or diagnostic
> laparotomy. So why
> complain when it does not do what it can't?  
> Why would one expect that a one day course on doing
> FAST will teach one a
> technique that radiologists take a life time to
> master?  Does a 2 day ATLS
> course make a trauma expert? 
> FAST is relieble for one thing and only one thing:
> detecting significant
> amount of blood/fluid in one or more of its three
> cardinal points.
> In these days of selective operative management, the
> information FAST
> yields (YES/NO to the blood question) is useful only
> in the unstable
> trauma patient.  
> We all knew (or shoud have known) that before we
> read the paper.
> Avi 

Reducto ad absurdum:  "And the internet was never
originally designed to replace the writing and posting
of letters.  So why complain to Microsoft when your
e-mail gets jumbled by a bug in their program?"  

The truths you espouse are not so self-evident to
everyone.  The fact is, FAST has and is being looked
at as a possible replacement for CT in blunt abdominal
trauma by many individuals and centers.  This paper,
and others, suggest that such a substitution is  not a
wise one.  Criticizing the paper becasue it "asks the
wrong question" appears to be misdirected.  The push
to use technology (like FAST) in new, different, and
potentially advantageous ways is a fundamental
principle of progress in any field.  If we sit back
and accept that FAST has reached its potential and
never question new applications of existing
technology, then progress is likely to grind to a
halt.  And you wouldn't want THAT, now would you?

C.M. Ursic, M.D.
UCSF-East Bay
Oakland, California

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