ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2020
The Utility of Focused Assessment With Sonography for Trauma Enhanced Physical Examination in Children With Blunt Torso Trauma.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 24 citations in OpenAlex.
- Article
- Reliability of Physician Estimation of Pelvic Free Fluid Volume on the Pediatric Focused Assessment With Sonography for Trauma.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025Article
- Evaluation of Focused Assessment With Sonography for Trauma Completeness of Children in the Clinical Setting.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2024Article
- Establishing the international research priorities for pediatric emergency medicine point-of-care ultrasound: A modified Delphi study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Article
- Development and Validation of a Deep Learning Strategy for Automated View Classification of Pediatric Focused Assessment With Sonography for Trauma.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2022Article
- Development of a Consensus-Based Definition of Focused Assessment With Sonography for Trauma in Children.JAMA network open · 2022Article
- The Efficiency of Focused Assessment with Sonography for Trauma in Pediatric Patients with Blunt Torso Trauma.Journal of emergencies, trauma, and shockArticle
- Consensus Recommendations of the Academic College of Emergency Experts in India on the Evaluation and Management of Polytrauma in Children Presenting to the Emergency Department in India.Journal of emergencies, trauma, and shockArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesComputed tomography (CT), the reference standard for diagnosis of intraabdominal injury (IAI), carries risk including ionizing radiation. CT-sparing clinical decision rules for children have relied heavily on physical examination, but they did not include focused assessment with sonography for trauma (FAST), which has emerged into widespread use during the past decade. We sought to determine the independent associations of physical examination, laboratory studies, and FAST with identification of IAI in children and to compare the test characteristics of these diagnostic variables. We hypothesized that FAST may add incremental utility to a physical examination alone to more accurately identify children who could forgo CT scan.
methodsWe reviewed a large trauma database of all children with blunt torso trauma presenting to a freestanding pediatric emergency department during a 20-month period. We used logistic regression to evaluate the association of FAST, physical examination, and selected laboratory data with IAI in children, and we compared the test characteristics of these variables.
resultsAmong 354 children, 50 (14%) had IAI. Positive FAST (odds ratio [OR] = 14.8, 95% confidence interval [CI] = 7.5 to 30.8) and positive physical examination (OR = 15.2, 95% CI = 7.7 to 31.7) were identified as independent predictors for IAI. Physical examination and FAST each had sensitivities of 74% (95% CI = 60% to 85%). Combining FAST and physical examination as FAST-enhanced physical examination (exFAST) improved sensitivity and negative predictive value (NPV) over either test alone (sensitivity = 88%, 95% CI = 76% to 96%) and NPV of 97.3% (95% CI = 94.5% to 98.7%).
conclusionsIn children, FAST and physical examinations each predicted the identification of IAI. However, the combination of the two (exFAST) had greater sensitivity and NPV than either physical examination or FAST alone. This supports the use of exFAST in refining clinical predication rules in children with blunt torso trauma.
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