The EFAST Exam QuickTime and a QuickTime and a QuickTime and a - - PDF document

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The EFAST Exam QuickTime and a QuickTime and a QuickTime and a - - PDF document

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3/22/2016 CONFLICT of INTEREST The EFAST Exam QuickTime and a QuickTime and a QuickTime and a QuickTime and a H.264 decompressor H.264 decompressor H.264 decompressor H.264 decompressor are needed to see this picture. are

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The EFAST Exam

John Lemos MD/MPH Staff Physician, Emergency Department Co-Director of Emergency Ultrasound Kaiser Permanente South Sacramento Critical US for Patient Care Conference 2016

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CONFLICT of INTEREST

  • NOTHING TO DISCLOSE

OBJECTIVES

Introduction Anatomy of the EFAST Acquiring/Interpreting Images

OBJECTIVES

Introduction Anatomy of the EFAST Obtaining/Interpreting Images

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What is the EFAST exam?

Focused Assessment with Sonography in Trauma (E = Extended FAST) Accessible Modality Rapid Triage Tool Reproducible & Repeatable Early ID Critical Pathology Vital Aid in Algorithms

Advantages of the EFAST

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Source of free fluid Type of Fluid Operator dependent

Limitations of Ultrasound

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EFAST Indications

RAPID TRIAGE HYPOTENSION BLUNT TRAUMA PROCEDURAL

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OBJECTIVES

Introduction Anatomy of the EFAST Obtaining/Interpreting Images

ANATOMY

PROBE & FREQUENCY

Low High High Low

ORIENTATION

Indicator on the probe to the RIGHT or the HEAD

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Scanning Technique

  • Slow adjustments
  • Hold at the base
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Scanning Technique

  • Proper probe grip
  • Brace yourself

Manipulating the Probe

  • “Sliding”
  • “Fanning”
  • “Rocking”
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OBJECTIVES

Introduction Anatomy of the EFAST Obtaining/Interpreting Images

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FAST EXAM

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FAST: RUQ

RUQ ANATOMY

Probe Placement

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Morrison’s Pouch

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Inferior Tip of the Liver

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FAST: LUQ LUQ ANATOMY Probe Placement LUQ

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Splenorenal Ligament

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FAST: Pelvis

PELVIC ANATOMY

TRANSVERSE LONGITUDINAL

PROBE ORIENTATION

BLADDER

PROBE PLACEMENT

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TRANSVERSE

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LONGITUDINAL

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MALE PELVIS

TRANSVERSE LONGITUDINAL

FEMALE PELVIS

TRANSVERSE LONGITUDINAL

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TRANSVERSE LONGITUDINAL

FREE FLUID FREE FLUID FAST: Cardiac CARDIAC ANATOMY

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PROBE PLACEMENT

HEART

PROBE PLACEMENT SUBXIPHOID VIEW

  • Cardiac Motion
  • Pericardial Effusion
  • Chamber Size and Function

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SUBXIPHOID VIEW

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LIVER RA LV LA RV

CARDIAC ANATOMY PATHOLOGY

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EFAST

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Use the Ribs to Orient you Probe Perpendicular to the Chest Wall Anchor your Hand

EFAST

Normal No sliding

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Normal Lung

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Pneumothorax

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Comet Tails & B-lines

Comet Tails B-lines Comet Tails and B-lines rule out pneumothorax in the rib space you are interogating

USE OF M-MODE

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M-Mode M-Mode

pleural Line pleural Line

Pleural Line Pleural Line

Normal Lung Normal Lung

M-mode M-mode

Stratosphere Sign Stratosphere Sign Barcode Barcode

pleural Line pleural Line pleural Line pleural Line

Pneumothorax Pneumothorax

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Questions ? Comments ? Thank You