focused assessment with sonography for trauma

AFHSR-Radiology Department! Hconnect.co, [email protected]

FAST

Focused Assessment with Sonography for Trauma

http://www.hconnect.co

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Focused exam using ultrasound to diagnose hemorrhage in a

trauma setting

!!Ideally takes < 3 min




Indications!!BAT(blunt abdominal trauma )!

Stable penetrating trauma!

Assessment of the degree of intraperitoneal free fluid




Contraindications!When emergency treatments such as intravenous (IV) fluids or transfusion of blood are indicated, performance of a FAST examination should not delay the initiation of these treatments.!!Although ongoing resuscitation and a patient in extremis are not contraindications, the FAST examination can be difficult to perform in such situations




4 primary views( for free fluid in corresponding areas)

RUQ (Perihepatic & hepato-renal space)

LUQ (Perisplenic)

Subxiphoid (Pericardium)

Suprapubic (Pelvis)




4 primary views

( for free fluid in corresponding areas)



By-Abdullah LaftalRadiology Department -AFHSR

PERIHEPATIC SCANNING


• The hepatorenal space (pouch of Rutherford-Morison) is the most dependent part of the upper peritoneal cavity and small amounts of intra-peritoneal fluid may collect in this region first.!!

• Blood shows as a hypoechoic black stripe between the capsule liver and the fatty fascia of the kidney.




The probe is placed in the right mid- to posterior axillary line at the level of the 11th and 12th ribs.




Normal
















PERISPLENIC SCANNING


The left upper quadrant examination visualises the spleen and perisplenic

areas.




The transducer is placed on the left posterior axillary line region between the 10th and 11th ribs.




normal




Abnormal




Blood in the splenodiaphragmatic recess.













PELVIC SCANNING


The pelvic examination visualises the cul-de-sac: the Pouch of Douglas in females and the rectovesical pouch in the male. It is the most dependent portion of the lower abdomen and pelvis, hence where fluid will collect.!!




The transducer is placed midline just superior to the symphysis pubis.




Normal
















PERICARDIAL SCANNING


The pericardial examination screens for fluid between the fibrous pericardium and the

heart, and hence possible cardiac tamponade.!

!




The transducer is placed just to the left of the

xiphisternum and angled upwards under the

costal margin.




Normal













1430 AH there was 484805 Road Traffic accidents. 5%(25033) of RTA were ( Sever with Deaths and injuries )!a total of 34605 were injured and transported to health facility for further management .

RTA IN SAUDI ARABIA

Source : Ministry of interior



http://www.moi.gov.sa/


Alexander Y. Sheng, et al. Emerg Med Int.

Percentage of patients in which a head CT, abdominal CT, and FAST were performed by year.

The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.





Percentage of patients in whom the result of the abdominal CT was negative by year.





Percentage of patients who received only one imaging modality of the abdomen in the ED by year.




CONTACT

alaftal @alaftal +AbdullahLaftal

!!E-Mail:! [email protected]



http://www.linkedin.com/in/alaftal



THANK YOU!



Health & Medicine

focused assessment with sonography for trauma