Pocus

Question 1

What can eFAST diagnose?

Answer 1

1. Pericardial effusion
2. Pneumothorax
3. Free fluid in abdomen

Question 2

How much needed in abdomen to be visible on US?

Answer 2

200cc - because of this 85% sensitivity

Question 3

Some false positives on FAST?

Answer 3

Ascites
Urine
Dialysate

Question 4

CXR or or eFAST better for pneumothorax

Answer 4

eFAST

Question 5

Different in eFAST algorithm in stable or unstable patient?

Answer 5

In stable, positive scan goes to CT

In unstable, positive scan goes to ER

Question 6

Characteristics of curvilinear probe?

Answer 6

Frequency: Low
Resolution: Low
Windows: Cardiac / abdominal
Penetration: 30 cm

Question 7

Characteristics of linear probe?

Answer 7

Frequency: high
Resolution: high
Windows: Thoracic cavities
Penetration: 6 cm

Question 8

How to image thoracic window?

Answer 8

1. Second ICS at MC line
   - 5 respiratory cycles
   - Indicator up, sagittal view
   - Move probe down chest to axillary line
   - Switch to M Mode once at pleural line
   - Can find pneumothorax

Question 9

How to image RUQ on eFAST?

Answer 9

1. Looking at Hepatorenal / “morrison’s pouch”
   - Indicator up to head
   - Mid axillary line, right flank
   - Oblique and coronal views
   - Diaphragm to lower pole of kidney

Question 10

How to image cardiac windows eFAST?

Answer 10

1. Sub xiphoid - parasternal long view (if xiphoid no good)
   - Identifies hemopericardium
   - Indicator to the right
   - Point to left shoulder
   - Liver / acoustic view

Question 11

How does free fluid look on US?

Answer 11

Black, Anechoic area

Question 12

What to do if can’t see heart in subxiphoid view?

Answer 12

Switch to parasternal long

Question 13

How to do parasternal long view?

Answer 13

1. Indicator to right elbow

2. To the left of xiphoid just below peck

Question 14

How to do LUQ fast?

Answer 14

“Splenorenal view”

1. Indicator up
2. Coronal view
3. Posterior to mid axillary line

Question 15

How to do suprapubic window in FAST?

Answer 15

1. Retrovesicular space
   - Pouch of douglas (retrouterine)
2. Indicator Right
3. Sagittal (to head) and transverse views (to right)

Question 16

Rx pulseless pericardial fluid?

Answer 16

Pericardiocentesis

Question 17

What does velocity of waves in US give us?

Answer 17

Depth

Question 18

What does frequency give us in US?

Answer 18

Definition

Question 19

What does low vs High frequency give us?

Answer 19

Higher: More detail
Lower: Penetration, better view deeper structures

Question 20

What does amplitude give us?

Answer 20

Brightness, more amplitude = brighter

Question 21

What does echogenicity mean?

Answer 21

Brightness

Question 22

What do anechoic waves appear as?

Answer 22

Black

Question 23

What does hyperechoic mean?

Answer 23

Brighter

Question 24

What is reflection?

Answer 24

Tissue too strong to penetrate so area behind appears as dark

Question 25

What tissues have high attenuation?

Answer 25

Gas / bone: do not allow waves to penetrate well

Question 26

Another name for longitudinal plain? Probe placement?

Answer 26

Sagittal

• Probe on front or back with indicator up
• Vertical (top to bottom cuts of tissue)

Question 27

Another name for transverse plain? Probe placement?

Answer 27

Axial

- Have probe on front or back of patient taking horizontal (left to right) images with indicator to right

Question 28

How to image coronal plane? Probe placement?

Answer 28

Probe on patient side with indicator up

- VErtical / top to bottom cuts

Question 29

What does changing gain do?

Answer 29

Increases brightness of all structures