Ultrasound eFAST vs. CT CAP in Blunt Trauma Patients: An Evidence-Based Comparative Analysis in Pakistan

Author(s): Sumbla Salman, Bushra Jawaid, Zahida Ismail, Bushra Saeed Khan, Nadhra Salman, Rabia Hameed, Iqra Anees Rajput, Hafiza Shabina, Zubair Nisar, Noman Ahmed Khan

Background: Blunt trauma accounts for 70-80% of traumatic injuries worldwide, necessitating rapid and accurate diagnostic imaging. The Extended Focused Assessment with Sonography for Trauma (eFAST) and Computed Tomography of the Chest, Abdomen, and Pelvis (CT CAP) are primary imaging modalities. This article compares the diagnostic accuracy, clinical utility, and impact on patient outcomes of these two methods in the context of blunt trauma.

Objective: The objective of this study was to compare the effectiveness of eFAST vs CT scan in Patients with blunt trauma.

Study Design: Prospective Cohort Study.

Duration: The study was conducted at the Shaheed Mohtarma Benazir Bhutto Trauma Centre (SMBBIT) over one year, from June 2024 to May 2025.

Methods: Patients who presented in the emergency department with blunt trauma and were stable enough to undergo both EFAST and CT scan were included in the study.

Results: CT CAP remains superior, with >95% sensitivity for solid organ injuries, retroperitoneal bleeding, and occult fractures. While eFAST is faster (3-5 minutes) and radiation-free, CT CAP provides a comprehensive evaluation but requires hemodynamic stability.

Conclusion: eFAST is invaluable for initial triage in unstable patients, while CT CAP is the gold standard for definitive diagnosis in stable blunt trauma. An integrated approach optimizes outcomes, particularly in high-risk patients