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1、TheFASTandE-FASTin2013:TraumaUltrasonographyOverview,PracticalTechniques,Controversies,andNewFrontiersSarahR.Williams,MD*,PhillipsPerera,MD,RDMS,LalehGharahbaghian,MDKEYWORDSTraumaFASTE-FASTUltrasoundPoint-of-careHemoperitoneumHemothoraxPneumothoraxKEYPOINTSTheFAST(FocusedAsses
2、smentwithSonographyinTrauma)andE-FAST(ExtendedFocusedAssessmentwithSonographyinTrauma)examinationsprovidecriticalinforma-tionduringthereal-timeevaluationofcomplextraumapatients,directlyatthebedside.TheFASTexaminationcanidentifyfreefluidsuggestiveofabdominalsolid-organinjury,hemothorax,
3、orpericardialfluidcollections.ThesensitivityofE-FASTforpneumothoraxandhemothoraxissuperiortothatofchestradiography.TousetheFASTandE-FASToptimally,physiciansmustbefamiliarwithboththeirstrengthsandtheirweaknesses.INTRODUCTION:TRAUMA“EPIDEMIC”Traumacontinuestobeamajorcauseofmorbidityandm
4、ortalityworldwide.Theper-centageofglobaldeathsattributabletoinjuriesin2010(5.1milliondeaths)washigherthan2decadesearlier.Thistrendwasdrivenprimarilybyaworldwide46%increaseindeathscausedbymotorvehiclecollisionsandfromfalls.1IntheUnitedStates,vigoroussafetyregulationsaswellasaninterdiscip
5、linarytraumacaresystemshaveprovidedrelativeprotectionfromfatalities,whichwereata60-yearlowin2011.However,earlystatisticsfrom2012suggestthatnumbersareagainontherise(anincreaseof7.1%).2Amongtheyoung(aged0–19years),DivisionofEmergencyMedicine,DepartmentofSurgery,StanfordUniversityMedicalCe
6、nter,300PasteurDriveAlwayBuilding,M121,Stanford,CA93405,USA*Correspondingauthor.E-mailaddress:srwilliams@stanford.eduCritCareClin30(2014)119–150http://dx.doi.org/10.1016/j.ccc.2013.08.005criticalcare.theclinics.com0749-0704/14/$–seefrontmatterÓ2014ElsevierInc.Allrightsreserved.120Willia
7、msetalunintentionalinjuriescontinuetobetheleadingcauseofdeath,withapproximately12,000annualfatalities.However,morethan9millionyoungpersonspresenttoemer-gencydepartments(EDs)yearlywithnonfatalinjuries.3Unfortunately,violentinjuriesalsocontinuetobeamajorcauseofdeathandmorbidity;a
