 |
| Free Fluid is fluid (most often blood) that shouldn't be present in that area |
FAST, Focused Assessment with Sonography for Trauma, is a
bedside ultrasound examination that focuses on four areas of the body to check
for ‘free fluid’ or blood in most cases. Ultrasounds are ideal in these
emergency settings because it is compact and can tell the team if the patient
is hemorrhaging in the abdomen, chest or around the heart within minutes. It provides
critical information without time delay from other machines like the Computed Tomography
(CT). Exams that use the CT are not only more time consuming, the patient must
be in the room alone without additionally medical care being given while being
scanned. With an ultrasound, the team can continue to stabilize the patient
while they are being scanned for internal bleeding. CT scans also has a lot of
radiation whereas ultrasounds do not and as a result, these patients are not
exposed to harmful radiation rays.
The four
areas that are checked during a FAST exam are the Perihepatic space, or the Hepatorenal
space (Morison’s pouch), perisplenic space, pericardium space and the pelvis.
The Perihepatic space, also known as hepatorenal recess or
Morison’s Pouch, is the space that separates the liver from right kidney. Under
normal conditions, this space is free of fluid, however when patients are
bleeding internally, fluid can collect in the abdomen. If this visual of fluid
in the hepatorneal space is caught quickly, the patient can immediately undergo
an urgent laparotomy which is a surgical procedure used to gain access into the
abdominal cavity. The surgeons then stop the source of the bleeding.
 |
| This is an ultrasound image of Morison's Pouch. The red arrow pointing to the black stripe shows fluid which indicates a positive fast exam. |
 |
| Arrow shows bleeding in area between the Diaphragm (D) and Spleen (S) |
The Pericardium space: checks for fluid/bleeding around the area of the
heart
 |
| Right Ventricle (RV), Tricuspid Valve (TV), Right Atria (RA), Left Vertical (LV), Mitral Valve (MV) and Left Atria (LA) |
The Pelvis: checks for fluid/ bleeding around the…you guessed it…Pelvis area.
.jpg) |
| Ultrasound image of a Bladder |
A positive FAST exam is when fluid
is spotted in one or more of these areas and often times, fluid in these areas
in a patient who is unstable (low blood pressure or high heart rate) signifies
a greater issue that needs to be fixed immediately in the operating room. I
will talk more about when a FAST ultrasound is preformed and how future
procedures for the patient are impacted by the FAST exam in future posts.
Even though
I didn’t know that ultrasounds were used regularly outside of prenatal care or
what Rhabdomyolysis was (the deterioration of muscle fibers that are released
into the blood stream which leads to complications like kidney (renal) failure.
My reaction: What?! Your muscles literally disintegrate into your blood!),
everyone is patient with me and open to answering all of my questions about
medical jargon as well as allowing me to hover over their shoulders to watch
them carry out procedures. I have also realized that even though my background
in biology, chemistry and physics have been useful, I have only scratched the
surface. Taking the basics of what I have learned from biology, I am able to
see it from a new perspective through its application here at the hospital.
This new perspective has already progressed my understanding and knowledge of
subjects that I once thought I knew so well
0 comments:
Post a Comment