Sensibilidade e especificidade do Focused Assessment for Sonography inTrauma - FAST no trauma abdominal, no Hospital Regional do Alto Vale - HRAV

Introducao: O Advanced Trauma Life Support - ATLSe uma forma hierarquizada de atendimento a pacientespolitraumatizados, diagnostico e abordagem de lesoes,que rapidamente poderiam leva-los a morte. Para detectare quantificar liquidos intra-abdominais nos politraumatizadospode ser usado o metodo ultrassonograficoFocused Assessment for Sonography in Trauma- FAST. Esta pesquisa foi realizada devido a importânciado trauma abdominal, seus metodos de diagnostico,das possiveis mortes evitaveis e por nao haver na regiaopesquisa relacionada ao trauma abdominal e aoFAST. Objetivo: Verificar a sensibilidade e especificidadedo FAST na triagem do paciente politraumatizadono HRAV ? Hospital Regional do Alto Vale. Metodo:De janeiro de 2009 a janeiro de 2010 foram avaliadosos pacientes com trauma abdominal do pronto socorrodo HRAV. Foram incluidos na pesquisa os pacientescom trauma abdominal, que apresentassem suspeitade hemoperitonio ou com forte dor abdominal. Esteseram avaliados pelo servico de cirurgia geral, seguindoo ATLS e solicitando o FAST, que era realizado pelo radiologista.Quando o resultado do FAST era positivo estavaindicado a laparotomia. Nos casos em que o resultadodo exame era negativo, procedia-se a observacaodo paciente e entao o exame poderia ser repetido sehouvesse instabilidade ou dor abdominal muito forte.Resultados: Foram selecionados 50 casos que contemplavamos criterios de inclusao. O FAST foi positivo em58% dos casos. Encontrou-se 100% de sensibilidadedo metodo neste periodo e 95% de especificidade.Conclusao: Nesta pesquisa pode-se concluir que o FASTrealizado no HRAV tem alta sensibilidade e especificidade,comparavel aos resultados encontrados na literatura,justificando a utilizacao deste metodo na rotina deatendimento aos politraumatizados nesta instituicao. Introduction: The Advanced Trauma Life Support-ATLS is a hierarchical form of tauma patient care, diagnosisand approach to injuries that could quickly leadthem to death. To detect and quantify intra-abdominalfluid in trauma patients can be used the Ultrasoundmethod Focused Assessment for Sonography in Trauma-FAST. This survey was conducted because of the importanceof abdominal trauma, their methods of diagnosis,possible preventable deaths and because there is noresearch in the region related to abdominal trauma andFAST. Objective: Check the sensitivity and specificity ofFAST screening of trauma patient on Regional Hospital? HRAV High Valley. Method: January 2009 to January2010 was evaluated patients with abdominal traumafirst aid HRAV. Were included in the search patientswith abdominal trauma, submit suspected bleeding orwith strong abdominal pain. These were evaluated bythe General Surgery service, following the ATLS and requestingthe FAST, which was accomplished by the radiologist.When the FAST result was positive was shownthe surgery. In cases where the result of the examinationwas negative, was the observation of the patientand so the examination could be repeated if there wasinstability or strong abdominal pain. Results: 50 caseswere selected which contemplated the inclusion criteria.The FAST was positive in 58% of cases. Find 100%of the sensitivity of the method in this period and 95%of specificity. Conclusion: In this study we can conclude that the FAST held at HRAV has high sensitivity andspecificity, comparable to the results found in the literature,justifying the use of this method in the routine ofservice to ones with this institution.