II. Indications
III. Criteria
- Abdominal wall Trauma signs or Seatbelt Sign
- Glasgow Coma Scale <14
- Abdominal tenderness on exam
- Thoracic wall Trauma
- Complains of Abdominal Pain
- Absent or decreased breath sounds
- Vomiting
IV. Interpretation
- All 7 criteria negative
- Very reassuring and unlikely to have intra-Abdominal Injury requiring intervention
- CT Abdomen not indicated unless for other criteria
- Any criteria positive
- Does not exclude significant intraabdominal injury
- Further evaluation required (e.g. imaging)
V. Efficacy
- Based on prospective study with over 12,000 patients, of whom 1.3% had a significant Abdominal Injury requiring intervention
- Study did not incorporate FAST Exam or labs in the decision rule (due to lack of standardization across study centers)
- Efficacy in identifying intraabdominal injury
- Test Sensitivity: 97% (higher than gestalt, which was 82.8%)
- Test Specificity: 42.5% (lower than gestalt, which was 78.7%)
- Negative Predictive Value: 99.9%
- Borgialli (2014) Acad Emerg Med 21: 1240-8 [PubMed]