Many clinicians are challenged when evaluating patients for perisplenic fluid as part of the FAST or RUSH examination. Here are some common problems and how to fix them. Fix probe location Make sure you are holding the probe in a longitudinal view, probe marker towards the patient’s head. Place the probe just above the costal margin,Read more
Blog
The FAST exam is generally described as a trauma assessment (hence the acronym). But it is often used as a metanym to mean any assessment of the peritoneum for fluid. In fact when I was a resident folks would often say, “let’s FAST that gallbladder,” or “get the FAST machine so we can put thatRead more
Ultrasound is quite sensitive in detecting even very small pleural effusions; it has been demonstrated to perform better than chest x-ray and nearly as well as CT scan. In order to assess for pleural fluid, the transducer should be directed through the liver (Right side) or spleen (Left side) and diaphragm. In a normal thorax,Read more
One common source of confusion or false positives in the FAST exam is the assessment of the left upper quadrant. We’ve already covered some tips on improving your view of the spleen. This post will illustrate how the stomach can mimic free fluid to the unprepared. The first image shows a perisplenic (left upper quadrant)Read more
The FAST exam is the prototypical application of emergency ultrasound. However, it is important to know that there are limited randomized controlled trials assessing the utility of the FAST exam. Despite this, let’s look at three good articles that all emergency residents should know. 1. In this Cochrane review, the authors’ conclusion was that thereRead more