Implementation of the Focused Assessment with Sonography for Trauma (FAST) Scan as a Diagnostic Adjunct in the Training for Medicine, Surgery and Anesthesia Residents.

Aiman Balouch; Tanzeel  Omer; Usama Ali; Ambreen  Farooq

doi:10.62497/IRABCS.2024.57

Authors

Dr. Aiman Balouch Khyber Medical University Institute of Medical Sciences, Kohat, Pakistan Author https://orcid.org/0009-0006-1840-3635
Dr. Tanzeel Omer Armed Forces institute of Radiological Imaging (AFIRI), Rawalpindi, Pakistan Author https://orcid.org/0009-0008-2806-3755
Dr. Usama Ali Pak International Medical College, Peshawar, Pakistan Author https://orcid.org/0009-0006-0291-0739
Dr. Ambreen Farooq Pakistan Institute of Medical Sciences, Islamabad, Pakistan Author https://orcid.org/0009-0000-5168-3401

DOI:

https://doi.org/10.62497/IRABCS.2024.57

Keywords:

Focused Assessment with Sonography in Trauma, FAST, training, clinical audit

Abstract

Introduction: Hemorrhages in most cases are caused by blunt trauma and are the leading factors in the cause of death in people below forty-five years of age. The diagnostic performance for distinguishing IPFF from other causes of acute abdominal pain is improved by the FAST scan, a noninvasive ultrasound-based method. This audit of participants aimed at assessing their current attitude towards this skill and to provide training to the anaesthesia, medicine, and surgery trainees on the utilization of this skill during emergency circumstances.

Methods: The study focused on the local clinical audit that provided an opportunity to create training resources for trainees on non-invasive processes. To evaluate the various aspects of FAST scan skills, 14 trainees from different specialties completed a survey. The next step involved the proposal of how to enhance these skills; this entailed practical training under the supervision of radiologists. Finally, self-ratings were obtained from the trainees in the post-training questionnaire in terms of their confidence levels using an eleven-point Likert scale.

Results: A majority of the participants were the post-graduate trainees in anesthesiology, medicine, and surgery. Initially, there were differing opinions on the advantages and limitations of FAST scan. Confidence levels notably rose after training, particularly in probe selection, adjusting image quality, and interpreting various perspectives and quadrants. Locating the left upper quadrant posed a challenge. The confidence interval for performing emergency scans was 50% for both moderate and high confidence levels.

Conclusion: This project emphasizes the significance of recognizing vital structures and identifying free fluid in both trauma and non-trauma patients. Initially, there was a lack of formal training in Focused Assessment with Sonography in Trauma, but trainees' confidence gradually increased from moderate to high levels. This progress sets the stage for formal training in this essential skill, promoting involvement in clinical audits and research projects to boost expertise, ultimately boosting confidence to conduct scans during emergencies.

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