Super fast FAST exam

EMS arrives with a 29 year old male who was involved in a head on collision on the interstate. He was in a high speed car chase in which he was running from the law after what he said was a “misunderstanding” at a bank. He states aliens told him they needed to borrow money, and he was simply trying to help them out. The misunderstanding involved the stealing of $5,000 dollars in gold Gringotts Galleons coins. He states he is a collector of memorabilia and wanted to add to his coin counts. He crashed into a semi in oncoming traffic.

On initial evaluation the patient was alert, talking, and had bilateral breath sounds. 2 IV’s are placed. His initial blood pressure is 87/57. Which the following is true?

A. Sensitivity decreases with Trendelenburg with the FAST exam

B. The FAST exam has higher specificity than sensitivity

C. Performing the FAST increases time it takes to go to the OR

D. In penetrating trauma, RUQ view should be obtained first

E. Direct peritoneal lavage is less sensitive than the FAST exam

Blake Briggs