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Old 04-21-2013
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Question When to do FAST?

This is confusing me, UWorld ID 3221 where pt has gunshot wound, why did they do FAST? I thought penetrating wounds to abdomen area is straight to surgery not wasting time doing imagning (UWorld Id 3420 states not waste time "Exploratory laparotomy should not be delayed for imaging in hemodynamically unstable patients" who have abdominal trauma. In both uworld questions the pt is unstable.
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Old 04-21-2013
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same doubt got here......waiting for someone's reply...
i thought FAST for unstable blunt trauma pt alone..
thanks for asking
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Old 04-22-2013
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Was thinking that since the stem mentions they used FAST then next best step is surgery. Else if the stem did not mention FAST as there management you and are left with FAST or surgery then go with surgery as the answer in GSW. Else if it is a BAT then go with FAST 1st.
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Old 04-22-2013
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uw clearly says for unstable patient do fast if patient is obese/fast inconclusive in hemodynamically unstable patient do DPL.....
ct scan is for hemodynamically stable patient

correct me if i m wrong
good luck
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Old 04-22-2013
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Quote:
Originally Posted by rupesh View Post
uw clearly says for unstable patient do fast if patient is obese/fast inconclusive in hemodynamically unstable patient do DPL.....
ct scan is for hemodynamically stable patient

correct me if i m wrong
good luck
ya you're right buddy.....but that's regarding blunt abd. trauma

here the question of FAST in penetrating trauma(like gunshot).....as already penetrated,why the need of it.........i thought immediate laparatomy would be the answer
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Old 04-22-2013
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I thought that if you have clear penetration wound then go for Surgery (not need to do imaging).

If BAT unstable -> FAST (if not showing the bleed then go for DPL)

If BAT stable -> FAST (if not showing the bleed then go for CT)

I think the write of the stem was trying to get you to pick surgery. But if it was not mentioned that FAST was done for the GSW then go for surgery no need to do FAST.
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