Abstract
Background
As the focused assessment with sonography for trauma (FAST) examination becomes increasingly
ubiquitous in the emergency department (ED), a parallel increase in incidental findings
can also be expected. The purpose of this study was to determine the prevalence, documentation,
and communication of incidental findings on emergency physician-performed FAST examinations.
Methods
Retrospective review at two academic EDs. Adult trauma patients undergoing FAST examinations
used for clinical decision-making at the bedside were identified from an ED ultrasound
image archival system. Expert sonologists reviewed ultrasound images for incidental
findings, as well as electronic medical records for demographic information, mechanism
of injury, type of incidental findings, documentation of incidental findings, and
communication of incidental findings to the patient.
Results
A total of 1,452 FAST examinations were reviewed. One hundred and thirty-seven patients
with incidental findings were identified (9.4%); 7 patients had an additional incidental
finding. Renal cysts were most common (49/144, 34.0%), followed by pelvic cysts in
women (32/144, 22.2%). While 31/144 (21.5%) incidental findings were identified and
documented in the ultrasound reports or medical records by ED providers, only 6/137
(4.4%) patients were noted to be informed of their incidental findings.
Conclusion
Incidental findings were often encountered in FAST examinations, with cysts of the
kidneys and pelvis being the most common findings. A vast majority of incidental findings
were not documented or noted to be communicated to patients, which can be a barrier
to follow-up care.
Keywords
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Article Info
Publication History
Published online: November 28, 2019
Accepted:
November 25,
2019
Received in revised form:
November 24,
2019
Received:
July 16,
2019
Footnotes
â?†Abstract presented at American College of Emergency Physicians Research Forum, Denver, Colorado, 10/2019.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
