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Emed > FAST Ultrasound > Flashcards

FAST Ultrasound Flashcards

1
Q

What does FAST stand for

A

Focused Assessment with Sonography for Trauma

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2
Q

What is FAST

A

It is U/S that is performed as part of the examination and resuscitation of the trauma patient

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3
Q

What is the purpose of the e-FAST

A

It is used when extra views are added to assess for pneumothorax

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4
Q

What is the purpose of FAST

A

To determine the presence of free fluid

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5
Q

How does FF (free fluid) appear on U/S

A

It is hypoechoic (dark grey) or anechoic (black)

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6
Q

What is the only contraindication for efast

A

Need for immediate surgery

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7
Q

5 indications of FAST

A
  • Blunt and penetrating trauma
  • trauma in pregnancy
  • trauma in pediatrics
  • undifferentiated hypotension
  • medical management of ascites
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8
Q

List 2 types of probes based on frequency

A

High Frequency
Low frequency

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9
Q

Discuss the advantages and disadvantages of high frequency vs low frequency probes

A

High frequency: low depth, high resolution

Low frequency: high depth, low resolution

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10
Q

List two types of “array” probes

A

Curvilinear Array (abdominal)
Small Footprint phased-array (cardiac)

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11
Q

List the 4 windows in FAST

A
  • subxiphoid
  • RUQ
  • LUQ
  • pelvic/ suprapubic
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12
Q

True or False

A

Clotted blood may appear echogenic

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13
Q

How do you describe a positive FAST

A

Any view that reveals an anechoic collection

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14
Q

How do you describe a negative FAST

A

If all views show no FF

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15
Q

How do you describe an indeterminate fast?

A

If any one view of the FAST cannot be adequately assessed

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16
Q

List 6 advantages of FAST

A

Easy to use
Portable
Noninvasive
Inexpensive
No ionizing radiation
Repeatable at bedside

17
Q

List 7 limitations of FAST

A

Sensitivity of 63-100%
Not definitive in ruling out intraabdominal injury
Can give false negatives:
- Diaphragm tears
- pancreatic lesions
- bowel perforations
- mesenteric trauma
Abd injuries that do not produce detectable amount of blood (>200ml)
Cannot distinguish between urine and blood
Limited by pt comorbidities

18
Q

Which comorbidities can limit the effectiveness of FAST

A

Severe obesity
Subcutaneous emphysema
Hyper inflated lungs from COPD

19
Q

What are the steps in the general technique for FAST

A
  • patient supine
  • rt side of patient
  • ask pt to place arm behind head
  • Trendelenburg position
20
Q

What manouvre improves the sensitivity of the FAST?

A

Trendelenburg

21
Q

What are the steps to obtaining the subxiphoid view in FAST

A
  • asses the pericardial space
  • place transducer inferior and to the right of the pt xiphoid process
  • aim the beam towards the left shoulder

(Hold breathe on inspiration)

22
Q

What structures are seen in the subxiphoid view of FAST

A

All 4 heart chambers
Liver (at the top of the screen)

23
Q

The subxiphoid view can be difficult in which patients

A

Obese
Prominent xiphoid process
Large volume of stomach gas
Small xiphoid angle
Tender or distended abdomen

24
Q

Where is the probe positioned in the right upper quadrant view

A

Mid axillaire line
10th intercostal space
Probe pointing towards the patient’s head

25
Q

What are the four spaces evaluated

A

Pleural
Subphrenic
Hepatorenal (Morrison’s Pouch)
Inferior pole of right kidney

26
Q

The “Spine Sign “ indicates what

A

This sign indicates that there is fluid in the lungs or pleural spaces that is allowing for transmission of the U/S waves to be able to view the vertebra (not normal obviously)

27
Q

What signs are seen in RUQ with a haemothorax

A

Anechoic line superior to the diaphragm

28
Q

Where is the probe place in the LUQ view

A

Posterior axillaire Line
8th intercostal space
Probe marker pointing to head

29
Q

What are the four spaces evaluated in the LUQ view

A

Pleural
Subphrenic
Splenorenal
Inferior pole of left kidney

30
Q

Where is the probe placed in the Pelvic view

A

Abdominal midline
Superior to pubic symphysis
Probe market to pts right
Rotate probe 90 degrees

31
Q

Where is the probe place in e fast

A

3rd/ 4th ICS MCL

32
Q

The diagnosis of Pneumothorax on B- Mode depends on the presence of what features

A

Identification of pleural membrane
Absent lung sliding
Absent Comet Tail Artifact

33
Q

The presence of a pneumot in M-Mode is confirmed by the presence of what feature

A

“Bar code sign “- Stratosphere sign

34
Q

In a haemodynamically unstable pt who had blunt abdominal trauma with a positive FAST, what is the next step

A

Laparotomy !!!!

35
Q

In a haemodynamically unstable pt who had blunt abdominal trauma with a negative FAST, what is the next step

A

Consider:
Non- Haem shock
Other sites of blood loss

Repeat FAST

36
Q

In a haemodynamically stable pt who had blunt abdominal trauma with a positive FAST, what is the next step

A

CT Scan

37
Q

In a haemodynamically stable pt who had blunt abdominal trauma with a negative FAST, what is the next step

A

Clinical observations
Serial exams

Repeat FAST
CT SCAN

Emed (2 decks)

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