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A question. Does anyone use scoring systems for amount of hemorrhage seen on CT like we use with AFAST?

Joe Nemeth, Dr joe.nemeth at mcgill.ca
Wed Jan 21 07:05:51 GMT 2015


Rob,

You are correct ...for the most part re: FAST's utility, however....

In a HD stable pt, a + FAST can also aid in:
-prioritization....of imaging (CT), personnel (alerting surgeon) and intervention in context of multiple pts
-although rare in blunt thoracic trauma, a positive PC view would definitely change where I go and what I do with the "HD" stable pt.

Now, if you are talking about the extended role of US...eFAST...it definitely has role in the HD stable pt. Sensitivities significantly better then CXR for picking up PTX/HTX. 

A bit off tangent, US can also aid in early detection of increased ICP (measuring optic n. Sheath diameters), confirming proper ETT placement, locating landmarks quickly for crycs, etc...but I digress .

Joe


Joe Nemeth MD CCFP EM
Director
Dept of Emergency Medicine
Montreal General Hospital   
McGill 
________________________________________
From: Robert Smith [rfsmithmd at comcast.net]
Sent: Tuesday, January 13, 2015 12:58 PM
To: Trauma-List at Trauma. Org
Subject: Re: A question. Does anyone use scoring systems for amount of  hemorrhage seen on CT like we use with AFAST?

Maybe the List can help me understand the role of FAST. I’m old and confused and it seems like its’ use has evolved. I thought FAST was for use in an unstable patient to see if the presence of blood in the abdomen indicated that this was the body cavity likely containing the injuries causing the instability. I thought this was a qualitative, not a quantitative test. I have not understood the practice of getting a FAST and then sending the patient to CT.

Help.

Rob

Robert F. Smith MD, MPH
Cook County Trauma (ret)



> On Jan 13, 2015, at 11:20 AM, Tim Crowe <tcrowedvm at gmail.com> wrote:
>
> A group of us in veterinary trauma are looking to a research project in bluntly traumatized K-9's where we correlate the finding of AFAST and the amount of hemorrhage detected (one of our investigators has developed a scoring system for   this). Then do a CT scan and compare the results obtained- hoping to see if we can validate the AFAST hemorrhage scoring from the results we get on the gold standard abdominal CT.
>
> Also planning to do a similar study regarding TFAST and thoracic CT.
>
> So appreciate any feed back and especially on any information on a scoring system for abdominal hemorrhage or thoracic hemorrhage and lung confusions from CT results in blunt trauma that anyone is currently using or have used in the last would be much appreciated.  Thank you.  D Tim Crowe, DVM, Diplomate Am Coll Vet Surgeons, Dip Am Coll Vet Emergency and  Critical Care, Fellow Am Coll Critical Care Med
>>> Chief of Surgery and Critical Care, Regional Institute for Veterinary Emergencies and Referrals,
> --
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