Hoffman et al evaluated patients with negative focused abdominal sonograms for trauma (FAST) for occult injury. They identified risk factors which may identify a patient who may benefit from additional imaging studies. The authors are from the University of Nebraska and the University of New Mexico,.


Patient selection: adult with blunt abdominal trauma and a negative FAST exam


Occult injury was a negative FAST exam and positive confirmatory test (abdominopelvic CT or exploratory laparotomy).


Predictors of occult injuries:

(1) pelvic fracture (odds ratio 3.5)

(2) renal trauma (odds ratio 3.7)


If the systolic blood pressure was < 100 mm Hg at any time during the resuscitation, then the odds ratio of a negative FAST and occult injury was 0.37 (probably because the FAST was usually positive).


To read more or access our algorithms and calculators, please log in or register.