{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T17:48:31Z","timestamp":1770227311435,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008069","name":"University of California, San Francisco","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the reliability of physician gestalt estimation of pelvic free fluid volume on pediatric Focused Assessment with Sonography for Trauma (FAST). To determine a reliable cut\u2010off volume and characteristics associated with small pelvic free fluid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our study assessed the ability of 2 ultrasound\u2010trained pediatric emergency medicine (PEM) physicians and 2 pediatric radiologists to characterize pelvic free fluid in a retrospective convenience sample of archived FAST from a Level 1 pediatric trauma center, April 2018\u2013June 2020. Inter\u2010 and intra\u2010rater reliability were measured to determine the most reliable volume cut\u2010off. Chi\u2010squared and Fisher's exact tests determined characteristics associated with physiologic fluid and fluid volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one (10.2%) of 797 FAST had pelvic fluid and met inclusion criteria. Volume estimates using none\/trace\/small versus moderate\/large classifications were moderately reliable by the PEM physicians (\u03ba\u2009=\u20090.65 [95% CI, 0.63\u20130.66]; raw agreement\u2009=\u200992%) and radiologists (\u03ba\u2009=\u20090.48 [95% CI, 0.47\u20130.49]; raw agreement\u2009=\u200991%). This volume cut\u2010off demonstrated higher reliability for both groups and greater agreement for PEM physicians than none\/trace versus small\/moderate\/large. Girls (<jats:italic>P<\/jats:italic>\u2009=\u2009.005), isoechoic (<jats:italic>P<\/jats:italic>\u2009=\u2009.045), and location posterior to bladder (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) were associated with physiologic fluid and hyperechoic (<jats:italic>P<\/jats:italic>\u2009=\u2009.019) with non\u2010physiologic fluid. Hyperechoic (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), anterior (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), lateral (<jats:italic>P<\/jats:italic>\u2009=\u2009.04), or \u201cother\u201d location (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) relative to the bladder were associated with moderate\/large volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultrasound\u2010trained PEM physicians and pediatric radiologists can reliably use gestalt estimation to distinguish moderate or large fluid from smaller pelvic fluid volumes on pediatric FAST.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16661","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T10:04:08Z","timestamp":1739441048000},"page":"1017-1025","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reliability of Physician Estimation of Pelvic Free Fluid Volume on the Pediatric Focused Assessment With Sonography for Trauma"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5866-4959","authenticated-orcid":false,"given":"Ashkon","family":"Shaahinfar","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9289-1493","authenticated-orcid":false,"given":"Jennifer Rosin","family":"Wiebelhaus","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Children's Mercy Kansas City  Kansas City Missouri USA"},{"name":"Division of Emergency Medicine UCSF Benioff Children's Hospital Oakland  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-1804","authenticated-orcid":false,"given":"Newton","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3143-8593","authenticated-orcid":false,"given":"Ronald A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9809-0846","authenticated-orcid":false,"given":"Pinar","family":"Karakas\u2010Rothey","sequence":"additional","affiliation":[{"name":"Department of Radiology UCSF Benioff Children's Hospital Oakland  Oakland California USA"},{"name":"Department of Radiology Nicklaus Children's Hospital  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1344-575X","authenticated-orcid":false,"given":"Aaron E.","family":"Kornblith","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1","article-title":"Deaths: leading causes for 2019","volume":"70","author":"Heron M","year":"2021","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0733-8627(05)70357-6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.11.009"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e3182259908"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6322"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15787"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.26377"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2000.tb02232.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2016.01.003"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001877"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.2922"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1998.17.7.431"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12132"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(90)90159-m"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(90)90158-l"},{"key":"e_1_2_7_17_1","first-page":"101","article-title":"Ultrasound and perforated viscus; dirty fluid, dirty shadows, and peritoneal enhancement","volume":"4","author":"Shokoohi H","year":"2016","journal-title":"Emerg (Tehran)"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.5847\/wjem.j.1920-8642.2022.018"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13959"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.12.041"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16417"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.16661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T08:50:50Z","timestamp":1749459050000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.16661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/jum.16661"],"URL":"https:\/\/doi.org\/10.1002\/jum.16661","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]},"assertion":[{"value":"2024-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}