Post on 08-Jul-2015
description
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
FAST
Focused Assessment with Sonography for Trauma
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Focused exam using ultrasound to diagnose hemorrhage in a
trauma setting
!!Ideally takes < 3 min
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Indications!!BAT(blunt abdominal trauma )!
Stable penetrating trauma!
Assessment of the degree of intraperitoneal free fluid
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
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
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
4 primary views( for free fluid in corresponding areas)
RUQ (Perihepatic & hepato-renal space)
LUQ (Perisplenic)
Subxiphoid (Pericardium)
Suprapubic (Pelvis)
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
4 primary views
( for free fluid in corresponding areas)
By-Abdullah LaftalRadiology Department -AFHSR
PERIHEPATIC SCANNING
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
• 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.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The probe is placed in the right mid- to posterior axillary line at the level of the 11th and 12th ribs.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Normal
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
By-Abdullah LaftalRadiology Department -AFHSR
PERISPLENIC SCANNING
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The left upper quadrant examination visualises the spleen and perisplenic
areas.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The transducer is placed on the left posterior axillary line region between the 10th and 11th ribs.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
normal
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Abnormal
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Blood in the splenodiaphragmatic recess.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
By-Abdullah LaftalRadiology Department -AFHSR
PELVIC SCANNING
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
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.!!
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The transducer is placed midline just superior to the symphysis pubis.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Normal
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
By-Abdullah LaftalRadiology Department -AFHSR
PERICARDIAL SCANNING
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The pericardial examination screens for fluid between the fibrous pericardium and the
heart, and hence possible cardiac tamponade.!
!
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
The transducer is placed just to the left of the
xiphisternum and angled upwards under the
costal margin.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Normal
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
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
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
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.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Alexander Y. Sheng, et al. Emerg Med Int.
Percentage of patients in whom the result of the abdominal CT was negative by year.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
Alexander Y. Sheng, et al. Emerg Med Int.
Percentage of patients who received only one imaging modality of the abdomen in the ED by year.
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
CONTACT
alaftal @alaftal +AbdullahLaftal
!!E-Mail:! alaftal@gmail.com
AFHSR-Radiology Department! Hconnect.co, alaftal@gmail.com
THANK YOU!