Mauro Zago (ed.)Ultrasound for Acute Care SurgeonsEssential US for Trauma: E-FAST201410.1007/978-88-470-5274-1_2
© Springer-Verlag Italia 2014
2. Introduction and Focused Questions
(1)
General Surgery Department, Minimally Invasive Surgery Unit, Policlinico San Pietro, Bergamo, Italy
Abstract
EFAST represents the basic US approach to trauma patient. Its impact on decision-making process in both physiologically normal and abnormal patients is strictly dependent on some key points: standardized protocols, trained and 24/7 available doctors performing the exam, clear and agreed institutional algorithms, and local resources. The decision-maker doctor(s) should be aware of the meaning and the limits of this tool in the hospital/setting and must be present for drawing conclusions from the US exam. A few focused questions can be answered by EFAST and should always be in the mind of the surgeon/physician performing the US exam.
EFAST (extended focused assessment by sonography for trauma) represents the basic US approach to trauma patient. Its role in trauma management algorithm is evolving over the years and depends from many factors:
Standardized and agreed institutional (not those found in literature) protocols including focused US
Trained surgeons/physicians in the team available and able 24/7 to perform US
Local resources
Different settings (prehospital, in-hospital, austere environment, etc.)
Local “political” constraints and resistance to the use of US by non-radiologists
If you are reading this book, you are certainly convinced of US being an invaluable tool for you in a context of quick decision-making. You want to know how to do it and how to use the findings you get on the screen, in both major and minor trauma. Before going through technical points, learning how to perform and to better include this exam in the management of your patients, remember you should ask EFAST for a few focused questions in order to benefit from a technologic “third hand.”