U.S. Army Combat Medic eFAST Performance with a Novel Versus Conventional Transducers: A Randomized, Crossover Trial.

Background: Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance between the novel and conventional ultrasound (US) transducers.

Methods: We conducted a randomized crossover trial. Medic participants, previously naïve to US, were randomized to the type of transducer first utilized. The primary outcome was eFAST completion time in seconds. Secondary outcomes included diagnostic accuracy, technical adequacy, and transducer ease-of-use rating.

Results: Forty medics performed 160 eFASTs. We found a statistically significant difference in eFAST completion times in favor of conventional transducers (304 vs. 358 s; P = 0.03). There was no statistically significant difference between the conventional and novel transducers in terms of diagnostic accuracy (97.7% vs. 96.0%; P = 0.25) and technical adequacy (65% vs. 72.5%; P = 0.11). Median transducer ease-of-use rating (Likert 1-5 scale) was statistically significant in favor of the conventional transducers (5 vs. 4; P = < 0.001).

Conclusions: Extended focused assessment with sonography in trauma exam times was faster with the conventional transducers. Combat medics performed diagnostically accurate eFASTs with both transducer types in a simulated aid station setting after a brief training intervention. Conventional transducers were rated higher for ease-of-use.