■ Major complications (bowel injury, bleeding, infection) have a 1% incidence.
■ A positive test is defined as drawing back 10 mL of blood initially or
100,000 RBC/μL (5000 RBC/μL for GSW and lower chest wounds) after
instilling 1 L of NS and allowing it to drain by gravity.
■ DPL has been largely replaced by CT and ultrasound in the evaluation of
blunt abdominal trauma.
Indications for Laparotomy
BLUNT
■ Abdominal injury (free fluid by FAST or blood by DPL) with hypotension
■ Evisceration through the abdominal wall TRAUMA
FIGURE 3.13. Positive FAST exam with fluid stripe in hepatorenal space.
(Courtesy of Michael J. Lambert, MD, RDMS as reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB.Atlas of
Emergency Medicine,2nd ed. New York: McGraw-Hill, 2002:616.)
FIGURE 3.14. Positive FAST exam with pericardial fluid.
(Courtesy of Paul R. Sierzenski, MD, RDMS, FAAEM as reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB.
Atlas of Emergency Medicine,2nd ed. New York: McGraw-Hill, 2002:614.)