The EFAST examination is easily achieved in most circumstances. Name 4 clinical situations which may limit the feasibility of the EFAST exam 4 limitations of the EFAST exam Morbid obesity - It is very difficult to get good penetration of ultrasound waves through morbidly obese patients which is a [...]
A 56 year old man presents to the Emergency department from another hospital for trauma assessment. Earlier that morning he had fallen off a roof and injured his chest and left hand. He has had 3 chest ultrasounds performed by 3 different operators and a pneumothorax was missed. It was [...]
Images Stuart Napier, text Genevieve Carbonatto A 24 year old presents to the emergency department with right upper quadrant pain after playing rugby. He tripped, landing on his right elbow jamming into his right upper quadrant. He was immediately winded and felt right upper abdominal pain. On waking the next [...]
A 26 year old man is brought to ED with a stab wound to his chest. The knife is still in situ is in the 4th intercostal midclavicular line. He has had a needle decompression for a presumed left pneumothorax and the needle is still in situ in the left [...]
Text and images Genevieve Carbonatto There is a BAT call. A young 35 year old has fallen from a 3 story building and essentially landed on his feet. He has extensive leg injuries and possible chest and abdominal injuries. BP 95/60 HR 110/min RR 25/min Saturating 96% on RA. The [...]
Images by Genevieve Carbonatto M mode Pneumothorax, stratosphere sign http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_1311.mp4 Right lung : Note absent lung sliding. If unsure in trauma change to linear probe to better visualise pleural line. http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_132.mp4 Left lung: Note absent lung sliding.
Images by Genevieve Carbonatto Splenic laceration and fractured rib. Free fluid below and above the diaphragm. http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_130.mp4 Note diaphragm separates the fluid which is below the diapgragm from that which is in the chest above it.
Images by Genevieve Carbonatto Free fluid in Morrison's pouch Fluid in LUQ
Images by Genevieve Carbonatto Pedestrian vs car, ruptured spleen. Free fluid in Morrison's pouch. http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_129.mp4
Images by Genevieve Carbonatto M mode shows stratosphere sign http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_127.mp4 No lung sliding, left lung http://www.criticalcare-sonography.com/wp-content/uploads/2017/02/Produce_128.mp4 Lung sliding + occasional B lines , right lung
