Công nghệ này khi kết hợp với khả năng truyền hình ảnh thời gian thực thông qua vệ tinh (y học từ xa), có thể cách mạng hóa các khái niệm về phân loại prehospital. Khái niệm về NHANH prehospital mặt đất dân sự và nhân viên aeromedical cũng đang được investigated56 và có khả năng thay đổi | FAST Focused Assessment by Sonography in Trauma 25 2 Figure 9. A Normal right thoracic view. B Positive right thoracic view with traumatic hemothorax and hemoperitoneum. From Sisley AC Rozycki GS et al. Rapid detection of traumatic effusion using surgeon-performed ultrasonography. J Trauma 1998 44 291 with permission. machine is ongoing. This technology when coupled with the ability to transmit real time images via satellite telemedicine could revolutionize the concept of prehospital triage. The concept of prehospital FAST by civilian ground and aeromedical personnel is also being investigated56 and is likely to change the way in which we triage the injured patient in the civilian setting. The ultrasound information made available from the scene might eventually influence the mode of transport the destination hospital and the more timely mobilization of the resources needed to best treat the injured patient. It is in this area that the FAST will probably show the most significant advances in the next five years. 26 Ultrasound for Surgeons 2 Figure10. Clinical course of patients with indeterminate abdominal sonograms. Modified from Boulanger BR Brenneman FD et al. The indeterminate abdominal sonogram in multisystem blunt trauma. J Trauma 1998 45 52 with permission. Summary The use of the Focused Assessment by Sonography in Trauma or FAST has been accepted as part of the standard of care in trauma centers across the United States over the last decade. The FAST is a noninvasive study that has proved to be as accurate specific and sensitive as CT scanning or DPL in the diagnosis of intra-abdominal or intrathoracic injury and is quickly becoming the new gold standard for the initial screening of the trauma patient. Ultrasound imaging of the trauma patient has markedly decreased the use of CT scanning and DPL in the trauma setting but should not be seen as their replacement. The FAST should instead be used by surgeons a second stethoscope and should be incorporated into
