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

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 needed to see this picture. are needed to see this picture. are needed to see this picture. • NOTHING TO DISCLOSE John Lemos MD/MPH Staff Physician, Emergency Department Co-Director of Emergency Ultrasound Kaiser Permanente South Sacramento Critical US for Patient Care Conference 2016 OBJECTIVES OBJECTIVES Introduction Introduction Anatomy of the EFAST Anatomy of the EFAST Acquiring/Interpreting Images Obtaining/Interpreting Images 1

3/22/2016 What is the EFAST exam? Advantages of the EFAST Accessible Modality Rapid Triage Tool Reproducible & Repeatable QuickTime™ and a H.264 decompressor are needed to see this picture. Early ID Critical Pathology Vital Aid in Algorithms Focused Assessment with Sonography in Trauma (E = Extended FAST) EFAST Indications Limitations of Ultrasound RAPID TRIAGE Source of free fluid BLUNT TRAUMA Type of Fluid QuickTime™ and a Animation decompressor are needed to see this picture. Operator dependent HYPOTENSION PROCEDURAL 2

3/22/2016 OBJECTIVES ANATOMY Introduction Anatomy of the EFAST Obtaining/Interpreting Images ORIENTATION PROBE & FREQUENCY Low High High Low Indicator on the probe to the RIGHT or the HEAD 3

3/22/2016 Scanning Technique Scanning Technique • Proper probe grip • Slow adjustments • Brace yourself • Hold at the base QuickTime™ and a H.264 decompressor are needed to see this picture. OBJECTIVES Manipulating the Probe Introduction • “Sliding” Anatomy of the EFAST • “Fanning” QuickTime™ and a DV/DVCPRO - NTSC decompressor QuickTime™ and a are needed to see this picture. Obtaining/Interpreting Images Motion JPEG OpenDML decompressor are needed to see this picture. • “Rocking” 4

3/22/2016 FAST EXAM FAST: RUQ QuickTime™ and a QuickTime™ and a QuickTime™ and a H.264 decompressor H.264 decompressor H.264 decompressor H.264 decompressor QuickTime™ and a are needed to see this picture. are needed to see this picture. are needed to see this picture. are needed to see this picture. RUQ ANATOMY Probe Placement 5

3/22/2016 Morrison’s Pouch QuickTime™ and a H.264 decompressor are needed to see this picture. QuickTime™ and a H.264 decompressor are needed to see this picture. Inferior Tip of the Liver QuickTime™ and a H.264 decompressor are needed to see this picture. QuickTime™ and a Animation decompressor are needed to see this picture. 6

3/22/2016 LUQ ANATOMY FAST: LUQ LUQ Probe Placement 7

3/22/2016 Splenorenal Ligament This image cannot currently be displayed. 8

3/22/2016 PELVIC ANATOMY FAST: Pelvis PROBE ORIENTATION PROBE PLACEMENT TRANSVERSE LONGITUDINAL BLADDER 9

3/22/2016 TRANSVERSE LONGITUDINAL QuickTime™ and a QuickTime™ and a H.264 decompressor H.264 decompressor are needed to see this picture. are needed to see this picture. MALE PELVIS FEMALE PELVIS TRANSVERSE LONGITUDINAL TRANSVERSE LONGITUDINAL 10

3/22/2016 FREE FLUID FREE FLUID TRANSVERSE LONGITUDINAL CARDIAC ANATOMY FAST: Cardiac 11

3/22/2016 PROBE PLACEMENT PROBE PLACEMENT HEART SUBXIPHOID VIEW • Cardiac Motion • Pericardial Effusion • Chamber Size and Function QuickTime™ and a MPEG-4 Video decompressor are needed to see this picture. 12

3/22/2016 CARDIAC ANATOMY SUBXIPHOID VIEW LIVER RV QuickTime™ and a H.264 decompressor are needed to see this picture. RA LV QuickTime™ and a H.264 decompressor are needed to see this picture. LA PATHOLOGY EFAST QuickTime™ and a H.264 decompressor are needed to see this picture. 13

3/22/2016 EFAST Probe Perpendicular to the Chest Wall QuickTime™ and a QuickTime™ and a H.264 decompressor H.264 decompressor are needed to see this picture. are needed to see this picture. Anchor your Hand Use the Ribs to Orient you Normal No sliding 14

3/22/2016 Normal Lung Pneumothorax QuickTime™ and a H.264 decompressor QuickTime™ and a H.264 decompressor are needed to see this picture. are needed to see this picture. Comet Tails & B-lines USE OF M-MODE Comet Tails B-lines Comet Tails and B-lines rule out pneumothorax in the rib space you are interogating 15

3/22/2016 M-Mode M-Mode Pleural Pleural Normal Lung Normal Lung Line Line pleural pleural Line Line M-mode M-mode Pneumothorax Pneumothorax pleural pleural Line Line pleural pleural Line Line Stratosphere Sign Stratosphere Sign Barcode Barcode 16

3/22/2016 Questions ? Thank You Comments ? 17