Prevalence, documentation, and communication of incidental findings in focused assessment with sonography for trauma (FAST) examinations.

TitlePrevalence, documentation, and communication of incidental findings in focused assessment with sonography for trauma (FAST) examinations.
Publication TypeJournal Article
Year of Publication2020
AuthorsValenzuela J, Stilson B, Patanwala A, Amini R, Adhikari S
JournalAm J Emerg Med
Volume38
Issue7
Pagination1414-1418
Date Published2020 07
ISSN Number1532-8171
KeywordsCommunication, Cysts, Documentation, Emergency Service, Hospital, Female, Focused Assessment with Sonography for Trauma, Humans, Incidental Findings, Male, Prevalence, Retrospective Studies
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.

DOI10.1016/j.ajem.2019.11.040
Alternate JournalAm J Emerg Med
PubMed ID31836347
Faculty Reference: 
Srikar Adhikari, MD, MS, FACEP
Richard Amini, MD
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