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== '''AFAST'''
'''A'''bdominal '''F'''ocused '''As'''sessment in '''T'''rauma/Triage ==
Developed as a technique for quick assessment in emergent patients. Only novice ultrasound skills are necessary to begin utilizing this tool.
Developed as a technique for quick assessment in emergent patients. Only novice ultrasound skills are necessary to begin utilizing this tool.
Procedure
== Procedure ==
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Right lateral recumbency
Right lateral recumbency
Place probe in 4 areas and assess if free abdominal fluid is present or not. For each position, give a score of 1 or 0.
Place probe in 4 areas and assess if free abdominal fluid is present or not. For each position, give a score of 1 or 0.
Positions are as follows:
Positions are as follows:
'''DH view''' (Diaphragmatic/Hepatic view)
'''DH view''' (Diaphragmatic/Hepatic view)
Probe is placed with ultrasound marker ventral on left side of screen.
Probe is placed with ultrasound marker ventral on left side of screen.
Organs to be identified:
Organs to be identified:
'''Caudal lung margin''' - can evaluate for pulmonary edema,
'''Caudal lung margin''' - can evaluate for pulmonary edema, nodules, pneumonia, PTE
'''Diaphragm''' - Evaluate for hernia
'''Liver''' - Evaluate for general liver size, echogenicity, obvious masses
'''Gall bladder''' - Evaluate for mucoceole, wall edema consistent with anaphylaxis
'''Peritoneal cavity''' - evaluate for free fluid
'''Caudal vena cava''' - evaluate size as it crosses the diaphragm. Collapsed - hypovolemia. Distended - R sided CHF vs volume overload. Expand and contract by 50% diameter is normal
'''Hepatic veins''' - distended consistent with volume overload or R sided CHF
'''Thoracic cavity''' - evaluate for pleural effusion
'''Pericardial sac''' - Evalaute for pericardial effusion
'''Heart apex +/- chambers''' - general idea of size and filling
'''Heart apex +/- chambers'''