FAST exam: Difference between revisions
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UTZ textbook | UTZ textbook |
Revision as of 13:21, 26 June 2016
Indication
- Prioritize: Do primary survery first ABC"U"D
- If blunt trauma start with noncardiac views first
- In penetrating start with cardiac views first - r/o tamponade
- Serial exams extremely helpful
Stable vs Unstable
- Views: hepatorenal, splenorenal, pelvis, pericardium
- Stable patient + negative FAST → observation
- Stable patient + positive FAST → CT
- Unstable patient + negative fast → repeat FAST or DPL
- Unstable patient + positive FAST → laparotomy
Procedure
- Always point dot to pt Rt (usu at 45 degrees) or @ pt head
- Morison's Pouch
- Best seen w/ probe around mid ax to ant ax line (esp w/ pt in trendelenburg)
- Pitfall: fan completely through (must visualize liver tip), assess pleural space
- Ultrasound: Renal
- Splenorenal
- Place probe in post ax line
- Pitfall: Look superior to spleen for fluid, not just splenorenal
- Troubleshooting: Slide probe as posteriorly as possible, have patient hold breath if able to
- Bladder
- Pitfall: turn down gain to view posterior bladder (posterior acoustic enhancement)
- Ultrasound: Bladder
- Cardiac
- Assess for pericardial effusion
- see Ultrasound: Cardiac
- E-FAST
- Add on pulmonary views to evaluate for pneumothorax
- Ultrasound: Lungs
See Also
- Ultrasound: Cardiac
- Ultrasound: IVC
- Ultrasound: Lungs
- Ultrasound (Main)
- Ultrasound: Renal
- Abdominal Trauma
- Ultrasound: In Shock and Hypotension
References
Sonoguide UTZ textbook