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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)

AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
PERIHEPATIC	
  SCANNING
Radiology Department -AFHSR

By-Abdullah Laftal
• 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
AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
PERISPLENIC	
  	
  SCANNING
Radiology Department -AFHSR

By-Abdullah Laftal
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
AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
PELVIC	
  SCANNING
Radiology Department -AFHSR

By-Abdullah Laftal
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
AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
PERICARDIAL	
  SCANNING
Radiology Department -AFHSR

By-Abdullah Laftal
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
RTA	
  IN	
  SAUDI	
  ARABIA	
  
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 .

Source	
  :	
  Ministry	
  of	
  interior
AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
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.
Alexander Y. Sheng, et al. Emerg Med Int.

AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
Percentage of patients in
whom the result of the
abdominal CT was negative
by year.

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

AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com
Percentage of patients who
received only one imaging
modality of the abdomen in the
ED by year.

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

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!

AFHSR-Radiology Department!

Hconnect.co, alaftal@gmail.com

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