FAST exam: Difference between revisions
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*In penetrating start with cardiac views first - r/o tamponade | *In penetrating start with cardiac views first - r/o tamponade | ||
*Serial exams extremely helpful | *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== | ==Procedure== | ||
*Always point dot to pt Rt (usu at 45 degrees) or @ pt head | *Always point dot to pt Rt (usu at 45 degrees) or @ pt head | ||
*Morison's Pouch | *Morison's Pouch | ||
**Best seen w/ probe around mid ax to ant ax line (esp w/ pt in | **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 | **Pitfall: fan completely through (must visualize liver tip), assess pleural space | ||
*[[Ultrasound: Renal]] | |||
*Splenorenal | *Splenorenal | ||
**Place probe in post ax line | **Place probe in post ax line | ||
| Line 16: | Line 24: | ||
*Bladder | *Bladder | ||
**Pitfall: turn down gain to view posterior bladder (posterior acoustic enhancement) | **Pitfall: turn down gain to view posterior bladder (posterior acoustic enhancement) | ||
**[[Ultrasound: Bladder]] | |||
*Cardiac | *Cardiac | ||
** Assess for pericardial effusion | ** Assess for pericardial effusion | ||
** see [[Ultrasound: Cardiac | **see [[Ultrasound: Cardiac]] | ||
*E-FAST | *E-FAST | ||
**Add on pulmonary views to | **Add on pulmonary views to evaluate for pneumothorax | ||
**[[Ultrasound: Lungs]] | **[[Ultrasound: Lungs]] | ||
==See Also== | ==See Also== | ||
*[[Ultrasound: Cardiac]] | |||
*[[Ultrasound: IVC]] | |||
*[[Ultrasound: Lungs]] | |||
*[[Ultrasound (Main)]] | *[[Ultrasound (Main)]] | ||
*[[Ultrasound: Renal]] | |||
*[[Abdominal Trauma]] | *[[Abdominal Trauma]] | ||
[[Ultrasound: In Shock and Hypotension]] | |||
==Source== | ==Source== | ||
Revision as of 20:33, 4 January 2015
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
Source
Sonoguide UTZ textbook