ORIGINAL ARTICLE
FAST GUIDED INITIAL TRIAGE OF POLYTRAUMA PATIENTS: A PROSPECTIVE EVALUATION OF DIAGNOSTIC TIMELINES

UDK: 616-001-036-083.98

Brzanov N1, Trpeski S1, Shosholcheva M2, Jovchevski V2, Srceva Jovanovski M1, Gavrilovska Brzanov A1

 

1University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Center, Faculty of Medicine, University of “SS Cyril and Methodius,” Skopje, R.N.Macedonia

2Faculty of Medicine, University “Ss. Cyril and Methodius”, Skopje, R.N. Macedonia

 

 

Abstract

Background: Polytrauma remains a leading cause of mortality worldwide. Rapid triage and timely diagnostic evaluation are essential for improving survival outcomes. Computed tomography (CT) remains the gold standard imaging modality, but logistical limitations often delay diagnosis in resource-limited settings. Focused Assessment with Sonography for Trauma (FAST) enables rapid bedside evaluation and early detection of life-threatening injuries. The objective of this study was to evaluate the impact of FAST on triage timing, diagnostic efficiency, and early management of polytrauma patients.

Material and methods: This prospective study included 40 patients assessed with FAST upon admission. Evaluated variables included demographics, mechanism of injury, FAST duration, diagnostic timings, intervention times, accuracy, ICU admission, complications, and mortality. FAST was performed at five standard anatomical views by a single trained physician. Statistical analysis included descriptive methods and Wilcoxon testing.

Results: Mean FAST duration was 5.12 minutes. FAST did not delay CT imaging nor the total diagnostic process (p >0.05). Accuracy was 92.5% for thoracic trauma and 85% for abdominal trauma. Surgical interventions were required in 42.5% of cases; while the median time to surgery was 2.42 hours. ICU admission was recorded in 55% of patients, and mortality reached 22.5%.

Conclusion: FAST significantly optimized early trauma triage without delaying CT or treatment. Its speed, accuracy, and bedside availability make FAST indispensable in emergency trauma care. The method is particularly beneficial in resource-limited environments. FAST should be integrated as a mandatory component of initial trauma protocols.

 

Key words: Diagnostic technologies; Focused Assessment with Sonography for Trauma; Polytrauma patients; Triage.

 

 

 

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