FAST exam - Revision history

Masoodrm: /* Pearls and Pitfalls */

2021-06-14T19:11:08Z

Pearls and Pitfalls

← Older revision		Revision as of 19:11, 14 June 2021
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	==Pearls and Pitfalls==		==Pearls and Pitfalls==
	*Morison’s pouch		*The area between the liver and kidney in the RUQ view is called Morison’s pouch
			*In the LUQ view, fluid is most likely to accumulate between the diaphragm and spleen, not between the spleen and kidney
	*Scans must scan through the inferior poles of the kidneys as this can contain small quantities of fluid		*Scans must scan through the inferior poles of the kidneys as this can contain small quantities of fluid
	*Serial exam may be needed		*Serial exam may be needed

Teaswift: /* Background */

2020-10-20T03:34:18Z

Background

← Older revision		Revision as of 03:34, 20 October 2020
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	==Background==		==Background==
	*"Focused assessment with sonography for trauma"		*"Focused assessment with sonography for trauma"
	*Prioritize: Do primary survey of ATLS first (ABCDE)		*Prioritize: Do primary survey of ATLS first ([[trauma_(main)#Primary_Survey.5B2.5D.5B3.5D.5B4.5D\|ABCDE]])
	*FAST exam follows ABCDE to assess “C” looking for free fluid		*FAST exam follows ABCDE to assess “C” looking for free fluid
	*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>		*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>

Rossdonaldson1: /* RUQ */

2019-08-17T20:15:48Z

RUQ

← Older revision		Revision as of 20:15, 17 August 2019
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	===RUQ===		===RUQ===
			[[File:Morrisons-with-fluid.jpg\|thumb\|A positive FAST - fluid (black stripe, indicated by red arrows) within Morison's pouch.]]
	#Location		#Location
	#*Coronal view over the right flank		#*Coronal view over the right flank
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	#*Visualize the interface between the liver and kidney		#*Visualize the interface between the liver and kidney
	#Scan anterior to posterior identifying Morison’s pouch and the superior and inferior pole of the kidney		#Scan anterior to posterior identifying Morison’s pouch and the superior and inferior pole of the kidney

	===Pelvic===		===Pelvic===
	#Location		#Location

Rossdonaldson1: /* Background */

2019-08-17T20:13:43Z

Background

← Older revision		Revision as of 20:13, 17 August 2019
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	==Background==		==Background==
	"Focused assessment with sonography for trauma"		*"Focused assessment with sonography for trauma"
	*Prioritize: Do primary survey of ATLS first (ABCDE)		*Prioritize: Do primary survey of ATLS first (ABCDE)
	*FAST exam follows ABCDE to assess “C” looking for free fluid		*FAST exam follows ABCDE to assess “C” looking for free fluid

Rossdonaldson1: /* Background */

2019-08-17T20:13:26Z

Background

← Older revision		Revision as of 20:13, 17 August 2019
Line 1:		Line 1:
	==Background==		==Background==
			"Focused assessment with sonography for trauma"
	*Prioritize: Do primary survey of ATLS first (ABCDE)		*Prioritize: Do primary survey of ATLS first (ABCDE)
	*FAST exam follows ABCDE to assess “C” looking for free fluid		*FAST exam follows ABCDE to assess “C” looking for free fluid

Rossdonaldson1: /* Cardiac */

2019-08-17T20:11:35Z

Cardiac

← Older revision		Revision as of 20:11, 17 August 2019
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	#*Include cardiac, RUQ, pelvic, and LUQ views		#*Include cardiac, RUQ, pelvic, and LUQ views
	===Cardiac===		===Cardiac===
			[[File:PericardialeffusionUS.png\|thumb\|Pericardial fluid on ultrasound]]
			[[File:Pericardial effusion with tamponade (cropped).gif\|thumb\|Transthoracic echo of pericardial fluid showing "swinging heart"]]
	#Location		#Location
	#*Subxiphoid		#*Subxiphoid
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	#*Visualize the heart and pericardium using the liver as an acoustic window		#*Visualize the heart and pericardium using the liver as an acoustic window
	#Scan anterior to posterior through the heart		#Scan anterior to posterior through the heart

	===RUQ===		===RUQ===
	#Location		#Location

Spenceemmett: /* Background */

2018-10-13T03:28:22Z

Background

← Older revision		Revision as of 03:28, 13 October 2018
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	*FAST exam follows ABCDE to assess “C” looking for free fluid		*FAST exam follows ABCDE to assess “C” looking for free fluid
	*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>		*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>
	*As little as 100 mL of free fluid can be seen<ref>Goldberg GG. Evaluation of ascites by ultrasound. Radiology. 1970; 96(15):217–221.</ref><ref>Von Kuenssberg Jehle D, Stiller G, Wagner D. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med. 2003 Oct;21(6):476-478.</ref>, though >~~500ml~~ is needed for the common user<ref>McKenney KL, McKenney MG, Cohn SM, et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma 2001; 50(4):650–654.</ref>		*As little as 100 mL of free fluid can be seen<ref>Goldberg GG. Evaluation of ascites by ultrasound. Radiology. 1970; 96(15):217–221.</ref><ref>Von Kuenssberg Jehle D, Stiller G, Wagner D. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med. 2003 Oct;21(6):476-478.</ref>, though >500 mL is needed for the common user<ref>McKenney KL, McKenney MG, Cohn SM, et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma 2001; 50(4):650–654.</ref>
	*If blunt trauma start with RUQ view first		*If blunt trauma start with RUQ view first
	*In penetrating start with cardiac views first to rule out tamponade		*In penetrating start with cardiac views first to rule out tamponade

Spenceemmett: /* Pearls and Pitfalls */

2018-10-13T03:27:24Z

Pearls and Pitfalls

← Older revision		Revision as of 03:27, 13 October 2018
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	*Serial exam may be needed		*Serial exam may be needed
	*Negative exam does not rule out intraabdominal injuries		*Negative exam does not rule out intraabdominal injuries
	*Retroperitoneal hemorrhage no easily identified		*Retroperitoneal hemorrhage not easily identified
	*Those with delayed presentation may have clotted and not completely anechoic fluid collections		*Those with delayed presentation may have clotted and not demonstrate completely anechoic fluid collections

	==Documentation==		==Documentation==

Spenceemmett: /* Background */

2018-10-13T03:25:03Z

Background

← Older revision		Revision as of 03:25, 13 October 2018
Line 1:		Line 1:
	==Background==		==Background==
	*Prioritize: Do primary survey of ATLS first ABCDE		*Prioritize: Do primary survey of ATLS first (ABCDE)
	*FAST exam follows ABCDE to assess “C” looking for free fluid		*FAST exam follows ABCDE to assess “C” looking for free fluid
	*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>		*Sensitivity of 42% and specificity of ≥98%<ref>Natarajan B, Gupta PK, Cemaj S, et al. FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 2010;148(4):695-700. </ref><ref>Miller MT, Pasquale MD, Bromberg WJ, et al. Not so FAST. J Trauma. 2003; 54(1):52-59.</ref>
	*As little as ~~100ml~~ of free fluid can be seen<ref>Goldberg GG. Evaluation of ascites by ultrasound. Radiology. 1970; 96(15):217–221.</ref><ref>Von Kuenssberg Jehle D, Stiller G, Wagner D. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med. 2003 Oct;21(6):476-478.</ref>, though >500ml is needed for the common user<ref>McKenney KL, McKenney MG, Cohn SM, et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma 2001; 50(4):650–654.</ref>		*As little as 100 mL of free fluid can be seen<ref>Goldberg GG. Evaluation of ascites by ultrasound. Radiology. 1970; 96(15):217–221.</ref><ref>Von Kuenssberg Jehle D, Stiller G, Wagner D. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med. 2003 Oct;21(6):476-478.</ref>, though >500ml is needed for the common user<ref>McKenney KL, McKenney MG, Cohn SM, et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma 2001; 50(4):650–654.</ref>
	*If blunt trauma start with RUQ view first		*If blunt trauma start with RUQ view first
	*In penetrating start with cardiac views first to rule out tamponade		*In penetrating start with cardiac views first to rule out tamponade

Bobzmac: /* Clips */

2018-02-28T18:30:26Z

Clips

← Older revision		Revision as of 18:30, 28 February 2018
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	File:Normal subxiphoid.gif\|Normal subxiphoid view		File:Normal subxiphoid.gif\|Normal subxiphoid view
	File:Bladder sagittal.gif\|Normal pelvic view		File:Bladder sagittal.gif\|Normal pelvic view
	~~File:FAST RUQ normal Bowra.gif\|Normal RUQ view~~
	</gallery>		</gallery>