{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T01:14:15Z","timestamp":1783127655096,"version":"3.54.6"},"reference-count":39,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2020,6,20]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the accuracy of extended focused assessment with sonography for trauma (EFAST) for chest and abdominal injuries performed by first responders in a tertiary care hospital of Nepal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study including all trauma patients who obtained either an Injury Severity Score \u226515\u2009or direct trauma to the trunk in 1\u2009year period in the emergency department (ED) of Dhulikhel Hospital-Kathmandu University Hospital. The results of the EFAST were then compared with contrast-enhanced CT (CECT), radiology ultrasound (USG)\/chest X-ray, or intraoperative findings when the EFAST was positive. The negative EFAST cases were observed for a minimum of 4\u2009hours in the ED. Descriptive statistics and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 267 cases, 261 patients underwent an EFAST examination. The sensitivity and specificity were 94.8% and 99.5%, respectively. The negative predictive value was 98.53% whereas the positive predictive value was 98.21%. The overall accuracy was 99.4%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study suggest that EFAST examination performed by first-line healthcare providers is a useful method for assessment of thoracic and abdominal injuries. EFAST was found to have a high specificity (99.5%) and positive predictive value (98.21%) which indicates that it is an effective technique for detecting intra-abdominal or thoracic injuries. However, the effectiveness of EFAST is limited by its being operator dependent, and thereby human error. For negative EFAST cases, we recommend a monitoring period of at least 4\u2009hours, serial fast scan, or further investigation through other methods such as a CECT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level I<\/jats:p><\/jats:sec>","DOI":"10.1136\/tsaco-2020-000438","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T06:27:26Z","timestamp":1596004046000},"page":"e000438","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal"],"prefix":"10.1136","volume":"5","author":[{"given":"Samjhana","family":"Basnet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanu Krishna","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok","family":"Pradhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshana","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anmol Purna","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grishma","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahil","family":"Bade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latika","family":"Giri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,28]]},"reference":[{"key":"2024110101554580000_5.1.e000438.1","first-page":"37","article-title":"The status of global road safety: the agenda for sustainable development encourages urgent action","volume":"27","author":"Peden","year":"2016","journal-title":"JACRS"},{"key":"2024110101554580000_5.1.e000438.2","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2007.018259"},{"key":"2024110101554580000_5.1.e000438.3","first-page":"27","article-title":"The burden of traumatic brain injury in Asia: a call for research","volume":"4","author":"Puvanachandra","year":"2009","journal-title":"Pak J Neurol Sci"},{"key":"2024110101554580000_5.1.e000438.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.039354"},{"key":"2024110101554580000_5.1.e000438.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200203000-00002"},{"key":"2024110101554580000_5.1.e000438.6","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1016\/j.ultrasmedbio.2015.05.009","article-title":"Trauma ultrasound","volume":"41","author":"Wongwaisayawan","year":"2015","journal-title":"Ultrasound Med Biol"},{"key":"2024110101554580000_5.1.e000438.7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.5847\/wjem.j.issn.1920-8642.2013.01.003","article-title":"Management of polytrauma patients in emergency department: an experience of a tertiary care health institution of northern India","volume":"4","author":"Payal","year":"2013","journal-title":"World J Emerg Med"},{"key":"2024110101554580000_5.1.e000438.8","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.ajem.2011.02.014","article-title":"Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage","volume":"30","author":"Wang","year":"2012","journal-title":"Am J Emerg Med"},{"key":"2024110101554580000_5.1.e000438.9","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1177\/000313481107700427","article-title":"Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan","volume":"77","author":"Nagarsheth","year":"2011","journal-title":"Am Surg"},{"key":"2024110101554580000_5.1.e000438.10","first-page":"1350","article-title":"Role of ultrasonography, computed tomography and diagnostic peritoneal lavage in abdominal blunt trauma","volume":"23","author":"Al-Salamah","year":"2002","journal-title":"Saudi Med J"},{"key":"2024110101554580000_5.1.e000438.11","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2003.005438"},{"key":"2024110101554580000_5.1.e000438.12","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S120145"},{"key":"2024110101554580000_5.1.e000438.13","unstructured":"Krantz B . 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