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Appendix E - Focused assessment with sonography in trauma
- Swaminatha V. Mahadevan, Stanford University School of Medicine, California, Gus M. Garmel, Stanford University School of Medicine, California
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- Book:
- An Introduction to Clinical Emergency Medicine
- Published online:
- 27 October 2009
- Print publication:
- 26 May 2005, pp 733-738
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- Chapter
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Summary
Background
The focused assessment with sonography in trauma (FAST) is an important bedside examination used primarily by emergency physicians and trauma surgeons to identify free intraperitoneal, intrathoracic, or pericardial fluid. Physicians in Europe and Japan have been using bedside ultrasound (US) in the routine evaluation of trauma patients for over 30 years. The FAST exam has gained wide acceptance in the United States in the past decade. No other imaging modality has the ability to diagnose critical traumatic conditions as quickly or as accurately as bedside US. Ultrasonographic techniques are noninvasive, do not expose patients to radiation, and are performed with relatively inexpensive portable equipment. In the initial assessment of trauma patients, abdominal US is now replacing diagnostic peritoneal lavage (DPL), and echocardiography has replaced invasive subxiphoid pericardiotomy. With increasing numbers of emergency medicine residency programs incorporating formal US training into their curriculum, its role in emergency medicine practice is being further solidified.
Equipment
Essential components of US equipment are accessibility, portability, reliability and ease of use. Most trauma centers now have portable machines on site ready to be wheeled to the bedside at a moments notice. While most machines come with a variety of transducers, the most commonly-used transducer for the FAST examination is a 3.5MHz microconvex transducer. The main advantage of the microconvex transducer is that the footprint can easily fit between the ribs when evaluating the upper quadrants and the heart.
Preface
- Edited by Diku P. Mandavia, University of Southern California, Edward J. Newton, University of Southern California, Demetrios Demetriades, University of Southern California
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- Book:
- Color Atlas of Emergency Trauma
- Published online:
- 10 November 2010
- Print publication:
- 15 September 2003, pp xv-xvi
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Summary
Good trauma care requires a substantial knowledge base and clinical skill. The comprehension and intuition required to treat trauma injury is gained over many years of clinical experience at the bedside of critically injured patients. The aim of this atlas is to share the experience of the authors from the largest trauma center in the United States and provide a solid companion to the many well-written textbooks on trauma management.
This project represents many decades of collective clinical experience. We have assembled one of the largest collections of trauma images to help bring the reader “to the bedside” of the patients. The majority of the photographs originate from the Los Angeles County-University of Southern California Trauma Center though some special photographs were donated from outside centers. The acquisition and final assembly of this collection of images was a difficult process and they were acquired with the gracious cooperation of our patients. We regularly use these images in our clinical teaching and hope this atlas will supplement other instructional resources in trauma management.
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