Focused Assessment with Sonography for Trauma (FAST)

Focused assessment with sonography for trauma is a point-of-care ultrasound examination protocol for the abdominal and thoracic cavities performed in the emergency room as part of the secondary survey in advanced trauma life support. The main goal of the FAST exam is to identify free intraperitoneal fluid (blood) and pericardial effusion Pericardial effusion Pericardial effusion is the accumulation of excess fluid in the pericardial space around the heart. The pericardium does not easily expand; thus, rapid fluid accumulation leads to increased pressure around the heart. The increase in pressure restricts cardiac filling, resulting in decreased cardiac output and cardiac tamponade. Pericardial Effusion and Cardiac Tamponade from trauma. As FAST requires only an ultrasound machine at the bedside and an experienced sonographer, it is widely available, quicker, and less invasive than other image modalities. Focused assessment with sonography for trauma has largely replaced diagnostic peritoneal lavage.

Last update:

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Table of Contents

Share this concept:

Share on facebook
Share on twitter
Share on linkedin
Share on reddit
Share on email
Share on whatsapp

Introduction

Definition

Focused assessment with sonography for trauma (FAST) is a point-of-care ultrasound (POCUS) examination protocol of the abdominal and thoracic cavities performed with the goal of identifying free intraperitoneal fluid and/or pericardial effusion Pericardial effusion Pericardial effusion is the accumulation of excess fluid in the pericardial space around the heart. The pericardium does not easily expand; thus, rapid fluid accumulation leads to increased pressure around the heart. The increase in pressure restricts cardiac filling, resulting in decreased cardiac output and cardiac tamponade. Pericardial Effusion and Cardiac Tamponade.

Background

  • History and physical exams often lack the necessary sensitivity and specificity to diagnose acute traumatic pathology of the abdomen accurately.
  • Free fluid within the peritoneal cavity settles into dependent areas within the peritoneum Peritoneum The peritoneum is a serous membrane lining the abdominopelvic cavity. This lining is formed by connective tissue and originates from the mesoderm. The membrane lines both the abdominal walls (as parietal peritoneum) and all of the visceral organs (as visceral peritoneum). Peritoneum and Retroperitoneum when the individual is supine and can be detected using ultrasound imaging.
  • Sensitivity of 42% and specificity ≥ 98% for free peritoneal fluid
  • 100 mL of free fluid can be seen, though > 500 mL is needed for the common user.
  • Pulmonary ultrasound (in the extended FAST (E-FAST)) has a sensitivity of 95%, specificity of 91%, and a negative predictive value of 100%.
  • Diagnostic peritoneal lavage (DPL) was previously used as the standard test to help physicians decide which individuals with trauma needed an emergent exploratory laparotomy Laparotomy Laparotomy is an open surgical exploration of the abdomen, usually through a single large incision. Laparotomy and Laparoscopy.
  • FAST has replaced DPL and is often beneficial over CT for many reasons.
Table: Advantages and disadvantages of the FAST exam
Advantages Disadvantages
  • Can be performed on any individual
  • Early operative determination
  • ↓ Time to diagnosis for acute abdominal injury
  • Accurately diagnoses hemoperitoneum
  • Noninvasive
  • Integrated into the primary or secondary survey
  • Can be performed quickly
  • Available at the bedside
  • Ease of use for serial examinations
  • Safe for use in pregnant individuals and children
  • ↓ Radiation than CT
  • Leads to ↓ DPL
  • Can lead to ↓ CT scans
  • Operator-dependent method
  • Only evaluates for the presence of blood within the peritoneal cavity and not its source
  • Distortion of images due to obesity Obesity Obesity is a condition associated with excess body weight, specifically with the deposition of excessive adipose tissue. Obesity is considered a global epidemic. Major influences come from the western diet and sedentary lifestyles, but the exact mechanisms likely include a mixture of genetic and environmental factors. Obesity, bowel gas, and subcutaneous air
  • Can miss diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm, bowel, and pancreatic injuries
  • Does not assess retroperitoneal structures
  • Does not visualize extraluminal air
DPL: diagnostic peritoneal lavage

Indications

  • Blunt abdominal trauma
  • Penetrating abdominal trauma without other indications for immediate laparotomy Laparotomy Laparotomy is an open surgical exploration of the abdomen, usually through a single large incision. Laparotomy and Laparoscopy

Contraindications

  • No absolute contraindications 
  • Should not delay resuscitation efforts

Findings

  • + FAST will have 1 of the following:
    • Anechoic area (blood) within the pericardial space
    • Anechoic area (blood) between the liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver and kidney
    • Anechoic area (blood) between the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm and spleen Spleen The spleen is the largest lymphoid organ in the body, located in the LUQ of the abdomen, superior to the left kidney and posterior to the stomach at the level of the 9th-11th ribs just below the diaphragm. The spleen is highly vascular and acts as an important blood filter, cleansing the blood of pathogens and damaged erythrocytes. Spleen
    • Anechoic area (blood) between the spleen Spleen The spleen is the largest lymphoid organ in the body, located in the LUQ of the abdomen, superior to the left kidney and posterior to the stomach at the level of the 9th-11th ribs just below the diaphragm. The spleen is highly vascular and acts as an important blood filter, cleansing the blood of pathogens and damaged erythrocytes. Spleen and kidney
    • Anechoic area (blood) between superior and posterior to the posterior wall of the bladder
  • + E-FAST can have 1 of the added findings:
    • Anechoic area (blood) above the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm between the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm and lung
    • Absent lung sliding
  • – FAST should be repeated if there is a change in the condition of the individual.
Decision making pathway for use of the fast

Decision-making pathway for use of the FAST exam in a trauma setting

Image by Lecturio. License: CC BY-NC-SA 4.0

Basics of Ultrasonography

Imaging

  • Sonography is an imaging technique based on ultrasound (high-frequency, inaudible sound waves). 
  • Sound waves having a frequency of 2–18 MHz are used in medical imaging.
  • The equipment utilizes a transducer acting as the emitter and receptor of sound waves, and a central computer processes the electrical signals to generate the image.

Terminology

  • Hyperechoic (e.g., surface of bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones, urinary tract Urinary tract The urinary tract is located in the abdomen and pelvis and consists of the kidneys, ureters, urinary bladder, and urethra. The structures permit the excretion of urine from the body. Urine flows from the kidneys through the ureters to the urinary bladder and out through the urethra. Urinary Tract calculi, fat-containing lesions): a structure that produces high-amplitude echo (lighter grays and white)
  • Hypoechoic (e.g., abscesses without gas, solid tumors without calcifications or fat): a structure that produces low-amplitude echo (darker grays)
  • Anechoic (e.g., simple cysts): a structure that produces no echo at all (looks completely black)
  • Isoechoic: a structure that produces an echo with an amplitude very similar to that of its environment, which is very difficult to distinguish
Imaging concepts of ultrasound

Imaging concepts of ultrasound

Image by Lecturio. License: CC BY-NC-SA 4.0

Probes

  • Curvilinear or convex probe:
    • “Abdominal probe”
    • 2–5 MHz (low frequency)
    • High penetration
    • Big footprint
    • Bad for movement
    • Used for most internal organs, the aorta, abdomen, lung, pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura, gynecology, FAST, E-FAST
  • Phased array probe:
    • “Cardiac probe”
    • 1–5 MHz (low frequency)
    • High penetration
    • Small footprint
    • Great for movement
    • Uses: cardiac, pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura, FAST, E-FAST
  • Linear probe:
    • “Vascular probe”
    • 6–13 MHz probe (high frequency)
    • Low penetration
    • Big footprint
    • Uses: vascular, pleural (in E-FAST), optic nerve, venous access

Exam

Select probe:

  • Curvilinear probe is ideal for all parts of FAST.
  • Cardiac probe can be used for cardiac window.
  • If E-FAST is performed, linear probe is used for pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura.

Location:

  • Sequence traditionally varies based on the mechanism.
  • Blunt trauma starts with RUQ view.
  • Most sensitive view for free peritoneal fluid
  • Penetrating trauma starts with cardiac view.
  • Rule out pericardial effusion Pericardial effusion Pericardial effusion is the accumulation of excess fluid in the pericardial space around the heart. The pericardium does not easily expand; thus, rapid fluid accumulation leads to increased pressure around the heart. The increase in pressure restricts cardiac filling, resulting in decreased cardiac output and cardiac tamponade. Pericardial Effusion and Cardiac Tamponade and (impending) tamponade.
  • Include cardiac, RUQ, pelvic, LUQ, and pulmonary views.

RUQ view (Morison’s pouch or hepatorenal fossa)

  • Probe placement:
    • Coronal view over the right flank
    • Right 8th to 11th ribs on the mid- or anterior axillary line
    • Probe must be held parallel to avoid rib shadows.
  • Landmarks:
    • Visualize the hepatorenal interface.
    • Space between the right lobe of the liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver and the right kidney = Morison’s pouch
  • Scan anterior to posterior and the superior and inferior poles of the kidney.
  • Liver tip is a common location for missed free fluid.
  • Intraperitoneal fluid + hemodynamic instability → exploratory laparotomy Laparotomy Laparotomy is an open surgical exploration of the abdomen, usually through a single large incision. Laparotomy and Laparoscopy
  • Anechoic image above the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm = pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion

Cardiac view (subxiphoid view)

  • Probe placement:
    • Subxiphoid process: The right and left ventricles should be visualized in a long axis.
    • Parasternal long, if abdomen is distended or subxiphoid view difficult to obtain
  • Landmarks:
    • Visualize the heart and pericardium.
    • Scan anterior to posterior through the heart.
    • Note: An anterior fat pad can give the impression of pericardial effusion Pericardial effusion Pericardial effusion is the accumulation of excess fluid in the pericardial space around the heart. The pericardium does not easily expand; thus, rapid fluid accumulation leads to increased pressure around the heart. The increase in pressure restricts cardiac filling, resulting in decreased cardiac output and cardiac tamponade. Pericardial Effusion and Cardiac Tamponade but should not be seen on posterior views.
    • An anechoic (black) stripe around the ventricles indicates pericardial effusion Pericardial effusion Pericardial effusion is the accumulation of excess fluid in the pericardial space around the heart. The pericardium does not easily expand; thus, rapid fluid accumulation leads to increased pressure around the heart. The increase in pressure restricts cardiac filling, resulting in decreased cardiac output and cardiac tamponade. Pericardial Effusion and Cardiac Tamponade
Ultrasound after chest injury showing pericardial tamponade

Resuscitative ultrasound image following a penetrating chest injury Penetrating chest injury Penetrating chest injuries (PCIs) are caused by an object puncturing the chest wall. Penetrating chest injuries can be high velocity, such as with gunshot wounds (GSWs); medium velocity, such as with pellet gunshots; or low velocity, such as with stab wounds. Penetrating Chest Injury illustrating the presence of a pericardial tamponade from a hemopericardium (*):
Arrowheads illustrate the wall of the right ventricle.
RA: right atrium
LA: left atrium
LV: left ventricle

Image: “Ultrasound after chest injury showing pericardial tamponade” by Regional Trauma Services, Calgary Heath Region and Foothills Medical Centre, Calgary, Alberta, Canada. License: CC BY 2.0

Left upper quadrant view (splenorenal view or splenorenal fossa)

  • Probe placement:
    • Similar to that for Morison’s pouch on the contralateral (left) side
    • Coronal view over the left flank
  • Landmarks:
    • Appears similar to Morison’s pouch view
    • Identify the space between the spleen Spleen The spleen is the largest lymphoid organ in the body, located in the LUQ of the abdomen, superior to the left kidney and posterior to the stomach at the level of the 9th-11th ribs just below the diaphragm. The spleen is highly vascular and acts as an important blood filter, cleansing the blood of pathogens and damaged erythrocytes. Spleen and diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm and the splenorenal interface.
  • Fluid collects cephalad to the spleen Spleen The spleen is the largest lymphoid organ in the body, located in the LUQ of the abdomen, superior to the left kidney and posterior to the stomach at the level of the 9th-11th ribs just below the diaphragm. The spleen is highly vascular and acts as an important blood filter, cleansing the blood of pathogens and damaged erythrocytes. Spleen, beneath the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm.
  • Anechoic image above the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm = pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion

Bladder view (pelvic)

  • Probe placement:
    • On the midline, immediately superior to the pubic bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones
    • Sagittal view, just superior to the pubic symphysis
  • Landmarks:
    • Identify the bladder.
    • Scan medial to lateral to identify the fluid posterior and superior to the bladder.
    • This view will be limited if the bladder is empty.
    • Free fluid appears as anechoic, posterior to the bladder.
    • In women, fluid collects in the space called the pouch of Douglas (rectouterine pouch).
Ultrasound of the bladder

Normal ultrasound scan of the bladder:
Blood/fluid can be seen above or below the bladder.

Image by Lecturio.

Extended FAST pulmonary view

  • Probe placement:
    • Coronal view over the right and left diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm (curvilinear probe)
    • Sagittal view over the midclavicular line between the 2nd and 3rd intercostal space (linear probe)
  • Landmarks:
    • Identify the interface between the diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm and lung on the right and left (curvilinear probe).
    • Identify lung sliding between 2 ribs over the anterior thorax (linear probe).
  • Visualization of both hemithorax is included in the protocol to assess the presence of:
    • Hemothorax Hemothorax A hemothorax is a collection of blood in the pleural cavity. Hemothorax most commonly occurs due to damage to the intercostal arteries or from a lung laceration following chest trauma. Hemothorax can also occur as a complication of disease, or hemothorax may be spontaneous or iatrogenic. Hemothorax
    • Pneumothorax Pneumothorax A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam. Pneumothorax
Placement of linear ultrasound

Placement of linear ultrasound probe for view of lung pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura and lung sliding in the evaluation for pneumothorax

Image by Lecturio.

Clinical Relevance

  • Sonography: an imaging technique based on ultrasound (high-frequency, inaudible sound waves). Sound waves having a frequency of 2–18 MHz are used in medical imaging. The equipment utilizes a transducer acting as the emitter and receptor of sound waves, and a central computer processes the electrical signals to generate the image. The general advantages of this type of imaging are its low cost, availability, and safety.
  • Hemopericardium (tamponade): the accumulation of excess fluid in the pericardial space around the heart, which increases pressure, restricts cardiac filling, and results in decreased cardiac output. Symptoms include dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, hypotension Hypotension Hypotension is defined as low blood pressure, specifically < 90/60 mm Hg, and is most commonly a physiologic response. Hypotension may be mild, serious, or life threatening, depending on the cause. Hypotension, muffled heart sounds Heart sounds Heart sounds are brief, transient sounds produced by valve opening and closure and by movement of blood in the heart. They are divided into systolic and diastolic sounds. In most cases, only the first (S1) and second (S2) heart sounds are heard. These are high-frequency sounds and arise from aortic and pulmonary valve closure (S1), as well as mitral and tricuspid valve closure (S2). Heart Sounds, jugular venous distension, and pulsus paradoxus. Diagnosis is confirmed with echocardiography. Management is emergent pericardiocentesis or pericardiotomy.
  • Hemothorax Hemothorax A hemothorax is a collection of blood in the pleural cavity. Hemothorax most commonly occurs due to damage to the intercostal arteries or from a lung laceration following chest trauma. Hemothorax can also occur as a complication of disease, or hemothorax may be spontaneous or iatrogenic. Hemothorax: collection of blood in the pleural cavity that most commonly occurs due to damage to the intercostal arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries. Affected individuals present with shortness of breath, chest pain Chest Pain Chest pain is one of the most common and challenging complaints that may present in an inpatient and outpatient setting. The differential diagnosis of chest pain is large and includes cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychiatric etiologies. Chest Pain, hypotension Hypotension Hypotension is defined as low blood pressure, specifically < 90/60 mm Hg, and is most commonly a physiologic response. Hypotension may be mild, serious, or life threatening, depending on the cause. Hypotension, tachycardia, decreased lung sounds, and dullness on percussion of the chest. Diagnosis is by chest X-ray. Management is with tube thoracostomy drainage, video-assisted thoracoscopic surgery (VATS), or thoracotomy.
  • Pneumothorax Pneumothorax A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam. Pneumothorax: a life-threatening condition in which air collects in the pleural space, leading to lung collapse. Individuals present with chest pain Chest Pain Chest pain is one of the most common and challenging complaints that may present in an inpatient and outpatient setting. The differential diagnosis of chest pain is large and includes cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychiatric etiologies. Chest Pain, dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, and diminished breath sounds. A diagnosis is made with imaging, though tension pneumothorax is a clinical diagnosis. Management is based on the size and stability of the affected individual and can include needle decompression and chest tube (thoracostomy) placement. 
  • Pleural effusion: fluid accumulation between the layers of the parietal and visceral pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura. Common causes of pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain Chest Pain Chest pain is one of the most common and challenging complaints that may present in an inpatient and outpatient setting. The differential diagnosis of chest pain is large and includes cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychiatric etiologies. Chest Pain, cough, and dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea. Management is dependent on the underlying condition and whether the effusion is causing respiratory distress.

References

  1. Roberts, J., Custalow, C., Thomsen, T. (2019). Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. Philadelphia, PA: Elsevier.
  2. Bloom, B.A., Gibbons, R.C. (2021). Focused assessment with sonography for trauma. StatPearls. Treasure Island (FL): StatPearls Publishing. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK470479/
  3. American College of Surgeons. (2018). Advanced trauma life support: Student course manual. Chicago, IL: American College of Surgeons.
  4. Natarajan, B., Gupta, P.K., Cemaj S, et al. (2010). FAST scan: Is it worth doing in hemodynamically stable blunt trauma patients? Surgery. 148, 695-700.
  5. Miller, M.T., Pasquale, M.D., Bromberg, W.J., et al. (2003). Not so FAST. J Trauma. 54, 52–59.
  6. Von Kuenssberg, J.D., Stiller, G., Wagner, D. (2003). Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med. 21, 476-478.
  7. McKenney, K.L., McKenney, M.G., Cohn, S.M., et al. (2001). Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma. 50, 650–654.
  8. Lichtenstein, D.A., Menu, Y. (1995). A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest. 108, 1345–1348.
  9. Chen, M.M., Whitlow, C.T. (2011). Chapter 1. scope of diagnostic imaging. Chen, M.M., & Pope, T.L., & Ott D.J.(Eds.). Basic Radiology, 2e. McGraw-Hill. https://accessmedicine-mhmedical-com.ezproxy.unbosque.edu.co/content.aspx?bookid=360&sectionid=39669007
  10. Zaer, N.F., Amini B, Elsayes, K.M. (2014). Overview of diagnostic modalities and contrast agents. Elsayes, K.M., Oldham, S.A.(Eds.). Introduction to Diagnostic Radiology. McGraw-Hill. https://accessmedicine-mhmedical-com.ezproxy.unbosque.edu.co/content.aspx?bookid=1562&sectionid=95875179

USMLE™ is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). MCAT is a registered trademark of the Association of American Medical Colleges (AAMC). NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN®). None of the trademark holders are endorsed by nor affiliated with Lecturio.

Study on the Go

Lecturio Medical complements your studies with evidence-based learning strategies, video lectures, quiz questions, and more – all combined in one easy-to-use resource.

Learn even more with Lecturio:

Complement your med school studies with Lecturio’s all-in-one study companion, delivered with evidence-based learning strategies.

User Reviews

0.0

()

¡Hola!

Esta página está disponible en Español.

🍪 Lecturio is using cookies to improve your user experience. By continuing use of our service you agree upon our Data Privacy Statement.

Details