https://doi.org/10.4081/ecj.2024.12696

Efficacy of EFAST-PS in pelvic trauma for the assessment of the pubic symphysis in emergency settings: a mini review

Early Access
Submitted: 29 May 2024
Accepted: 29 September 2024
Published: 11 October 2024
EFAST, FAST, EFAST-PS, trauma, pubic symphysis, pelvis, ultrasound, pelvic injuries, intra-abdominal bleeding, pelvic binder
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Authors

Federica Piazzai
Emergency Department, Azienda USL Toscana Sud Est, Italy.
Gilda Morelli
Rehabilitation Facility, Istituto Anna Torrigiani, Italy.
Lorenzo Barone
Intensive Care Unit, Azienda USL Toscana Centro, Ospedale Santa Maria Annunziata, Italy.
Manuel Carli
Emergency Department, IRCCS Ospedale Sacro Cuore Don Calabria Negrar di Valpolicella, Italy.
Chiara Borchi
IRCCS Don Carlo Gnocchi, Firenze, Italy.
Moris Rosati
moris.rosati@unisi.it
https://orcid.org/0009-0006-4332-5077
Cardiology and Cardiac Intensive Care Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy.
Lorenzo Righi
https://orcid.org/0000-0003-4638-118X
Emergency Department, Azienda USL Toscana Sud Est, Italy.
Sara Montemerani
https://orcid.org/0000-0001-9208-5360
Acceptance and Emergency Medicine and Surgery Unit, San Donato Hospital in Arezzo - Pegaso 2 Helicopter Service, Emergency Department, Azienda USL Toscana Sud Est, Italy.

The EFAST technique is a rapid ultrasound method introduced into ATLS guidelines since 2006 for the evaluation of trauma patients. It allows for the detection of free fluid in the abdomen, pericardial tamponade, and pneumothorax within 2 to 3 minutes without impacting management times in pre-hospital settings. Recently, the EFAST-PS protocol has been introduced, which includes an additional scan of the pubic symphysis to identify “open book” pelvic fractures. This mini review examines the efficacy of the EFAST-PS protocol in pre-hospital environments through a literature review and analysis of a clinical case. It is demonstrated that EFAST has high specificity and sensitivity in detecting free fluid in abdominal and thoracic recesses, improving the management of trauma patients and reducing time to definitive intervention. The addition of the pubic symphysis scan did not cause any issues but increased safety in managing patients with suspected fractures and hemodynamic instability. Emergency ultrasound assessment, including the EFAST-PS protocol, should be integrated into the overall clinical picture to provide useful data for the decision-making process.

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How to Cite

Piazzai, F., Morelli, G., Barone, L., Carli, M., Borchi, C., Rosati, M., Righi, L., & Montemerani, S. (2024). Efficacy of EFAST-PS in pelvic trauma for the assessment of the pubic symphysis in emergency settings: a mini review. Emergency Care Journal. https://doi.org/10.4081/ecj.2024.12696
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