{"id":5468,"date":"2011-07-14T20:26:45","date_gmt":"2011-07-15T00:26:45","guid":{"rendered":"http:\/\/crashtext.org\/misc\/focused-assessment-with-sonogram-in-trauma.htm\/"},"modified":"2013-09-22T10:54:30","modified_gmt":"2013-09-22T14:54:30","slug":"focused-assessment-with-sonogram-in-trauma","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/ultrasound\/focused-assessment-with-sonogram-in-trauma.htm\/","title":{"rendered":"Focused Assessment with Sonogram in Trauma (FAST Exam)"},"content":{"rendered":"

\"Acad-Emerg-Med-1995-2-407\"<\/a><\/p>\n

 <\/p>\n

<\/span>Focused Assessment with Sonogram in Trauma<\/span><\/h2>\n

Trauma: The FAST Exam Anywhere from 1-7 views Use sector probe 2-3.5 MHz Each view should take 30-60 seconds<\/p>\n

<\/span>RUQ<\/span><\/h3>\n

Most sensitive view for free fluid in peritoneal space Made more sensitive by scanning in Trendelenburg. 97% sensitivity c 1 L of fluid, 10 % Sensitivity with 400 cc Attempt the scan in sagittal at right midclavicular line moving the probe laterally until kidney\/liver interface comes into view. From this position, you can see Morrison\u0092s, check for pleural effusion (sensitivity increased with patient flat or in reverse Trendelenburg,) examine paracolic gutters and the liver parenchyma.<\/p>\n

If you must scan RUQ in coronal, placing arms over head will open up intercostals spaces. Scan in oblique just off coronal with probe on mid-ax line and indicator pointing towards post-ax line Blood\/fluid collections have sharp edges and points b\/c it will fill the space between structures. Blood is anechoic, but if there are clots, will be hypoechoic. Liver level signals should be seen on both sides of the diaphragm, if there is an anechoic area opposite liver tissue, it is pleural fluid.<\/p>\n

RUQ mean volume required to detect fluid in a dialysis model was 619 cc, at 1 liter, sensitivity was 97%)<\/p>\n

Double-Line Sign<\/h4>\n

An aritfact of two bright lines with hypoechoic area between. Fascia and fat is what’s is causing the artifact. Fluid next to liver will only have one white line.<\/p>\n