Triage Quick Fire (GFAST) Flashcards
What is included in a GFAST scan?
AFAST, TFAS, VetBlue (POCUS)
What are the 4 views in a VetBlue/POCUS?
Scan L and R = 4 views each side
- Caudo-dorsal view
- Peri-hiar view
- Middle lung view
- Cranial lung view
What are A-lines?
Found on a normal lung - reverberation artefact caused by a normal airated lung.
What is a glide sign?
The parietal and visceral layers gliding over each other.
Not there = pneumothorax
What are B lines?
Fluid in the lungs = pulmonary oedema, pulmonary contusions (blood) or acute pneumonia.
Count the number and monitor for progression.
Cannot count = infinity B line
What is a shred signs?
Loss of all air in the alveoli - alveoli flooded = pneumonia, haemorrhage, oedema
Cloudy appearance
What is a tissue sign?
Lung consolidation - appearance of a liver.
Severe pneumonia or lung lobe torsion.
If you do not see a nodule on a POCUS, does that rule out tumour?
NO! POCUS only looks at the surface of the lung, nodules can still be present deeper in the lung. Need to radiograph to confirm.
How can you differentiate between a pericardial effusion and pleural effusion?
Pleural effusion = fluid goes wherever it wants to.
Pericardial fluid = fluid envelopes the heart
A POCUS is graded: 1, 2, 3, &
How is it graded?
Count the number of B-lines present
& = infinity lines (too many to count)
What does this POCUS view suggest:
L: >3 >3 0 0 R: >3 >3 0 0
Pulmonary oedema (cardiogenic or non-cardiogenic)
> 3 B-lines in caudo-dorsal and perihilar views bilaterally
0 B-lines in mid- and cranial-lung fields bilaterally
Fluid is sinking (gravity dependent)
In cardiogenic pulmonary oedema, fluid often accumulates:
- Perihilar region (classic in left-sided CHF)
- Caudo-dorsal fields (gravity-dependent)
What does this POCUS view suggest:
L: 0 0 >3 >3 R: 0 0 >3 >3
Bronchopneumonia
Fluid is in the cranial lobes = from something has been inhaled.
What does this POCUS view suggest:
L: 0 0 0 0 R: 0 0 >3 0
Aspiration pneumonia - typically found in the right middle lung lobe.
How many views are there in a TFAST protocol? And what are they?
5 views:
2 x Pericardial site (R and L)
2 x Chest tube site (R and L)
1 x Diaphragmatico-Hepatic (midline)
In the right pericardial site on a TFAST, what are you measuring?
LA: RA (normal 1:1)
RV: LV (normal 1:3)
LA: Ao (normal 1:1)
Ejection fraction (normal ~ 40% = how much the LV reduced in size by)
Answer the following questions about a TFAST:
Is there is an increased ejection fraction, what does this represent?
LA is enlarged, but the LA:RA ratio is normal, what does this mean?
RV: LV = 1:1
In the LA:AO measurement, when is it considered to be enlarged>
Increased ejection fraction = LV reducing in size more = hypovolaemia
LA:RA = 1:1 = if LA enlarged, then RA is also enlarged
RV:LV should be 1:3 = if it is 1:1 = RV is enlarged
LA:Ao = enlarged >1.6
What are the views of an AFAST?
5 views in total
- Diaphragmatic Hepatic view
- Spelno-renal view
- Cysto- colic view
- Hepato renal view (most likely see GI and spleen)
- Umbilical view (optional)
On a A-Fast, what does a gallbladder halo sign represent?
Anaphylaxis (dogs) - not definitive
Increased hydrostatic pressure
Reduced oncotic pressure
Increase vascular permeability
On a A-Fast, what do the follow findings from measure the CVC suggest?
- Flat and static
- Flat
- Bounding (<40-50% change)
Looks at the change in size of CVC of blood moves from CVC to RA.
- Flat and static = congestion/fluid overload
- Flat = hypovolaemia (>50% change)
- Bounding (<40-50% change) = normovolaemia
