Chest Abdominal-Focused Assessment Sonography for XXXX during the primary survey in the Emergency Department: the CA-FAST protocol.

@entity1 @entity358 @entity2286 @entity130
PURPOSE: To evaluate the feasibility of a new protocol, Chest Abdominal-Focused Assessment Sonography for @entity130 (CA-FAST), during the primary survey and to estimate its diagnostic accuracy when compared with thoracoabdominal computed tomography (CT) scan. METHODS: A prospective accuracy study was performed from November 2012 to November 2013 at the Emergency Department. Only adult @entity130 @entity1 who underwent a CA-FAST examination prior to a thoracoabdominal CT scan were enrolled. In addition to standard patterns detected by Extended-FAST (E-FAST) such as pneumothorax (PTX), hemothorax (HTX), pericardial and intraabdominal effusion, CA-FAST protocol also included the @entity358 (LCs). RESULTS: Six hundred and one @entity1 were enrolled. The mean time for protocol execution was 7      3  min. Chest ultrasonography showed the following results (all p  <  0.001): LCs sensitivity 59  %, specificity 98  %, positive predictive value ( @entity2286 ) 92  %, negative predictive value (NPV) 86  %, accuracy 87  %; PTX sensitivity 84  %, specificity 98  %, @entity2286 93  %, NPV 95  %, accuracy 95  %; HTX sensitivity 82  %, specificity 97  %, @entity2286 87  %, NPV 95  %, accuracy 94  %. The standard 4-views FAST examination showed a diagnostic accuracy of 91  % with a sensitivity of 75  %, specificity of 96  %, @entity2286 of 81  % and NPV of 94  %. CONCLUSION: According to our results CA-FAST protocol proved to be a rapid bedside method, with good accuracy and high NPV in detection of ultrasonographic patterns suggestive of @entity130 in @entity130 @entity1 ; moreover, the additional research of LCs did not cause a delay in the diagnosis. Ultrasonography should be used as initial investigation during the primary survey, sending to further diagnostic studies (CT scan) only those @entity1 not clearly classified.
