 Ministry of Health
http://newzealand.govt.nz/
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Published:
28/11/2011
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FAST
DPL is steadily being replaced by a focused ultrasound assessment (FAST,
focused assessment by sonography for trauma).
This is a four quadrant ultrasonographic assessment of the abdomen done by a
credentialled operator in the resus room looking at:
- The Hepatorenal pouch (of Morrison).
This is the RUQ scan and should be done first, as it is the most sensitive
for fluid identification. If it is positive there is no need to go on to the
other four quadrants unless a pericardial effusion is suspected.
- The Subphrenic/Splenic Recess.
This can be the hardest scan to do
and is looking for fluid between the spleen and L) kidney.
- The Suprapubic Region. This looks for fluid in the pelvis. This
scan can be misleading, as fluid tracking from a pelvic fracture may be
present. Also in women there may be fluid present in the pouch of Douglas
that could be physiological.
- The Sub-Xiphisternal/Pericardial View.
This can be useful for both
blunt and penetrating trauma in identification of pericardial tamponade.
The FAST scan should take between 1-5minutes and has the advantage that it is
repeatable and non-invasive. The FAST operator should document the findings in
the notes. When a credentialled operator is present, this investigation has
acceptable sensitivity to exclude haemoperitoneum, cardiac tamponade and pleural
fluid or blood.
see DPL
Last updated on
28/11/2011 |
