Life in the eFAST Lane: Sonography for Trauma (Part 3)
Getting to the Point of Ultrasound Assisted LPs
Life in the eFAST Lane: Sonography for Trauma (Part 2)
Life in the eFAST Lane: Sonography for Trauma (Part 1)
Keeping an Eye on Intracranial Pressure: Detecting Elevated ICP Using Ocular Ultrasound
Call for Ultrasound Interest Groups!
Learning Ultrasound in Ultrasound Naive Learning Environments
Orientation & Ultrasound Resources Module
Intro to Bedside Ultrasound Module
RUSH Protocol Module
Female Pelvic Ultrasound Module
Musculoskeletal Ultrasound Module
Useful Ultrasound Protocols Module
Ultrasound in Medical Education Module
Ultrasound Guided Vascular Access Module
Ultrasound Guided Nerve Blocks Module
More Ultrasound Guided Procedures Module
This is the first of a three part series reviewing the eFAST scan in detail. The goal of this series is to aid new ultrasound users to perform their first eFAST scan correctly and improve existing sonographer’s understanding of the eFAST.
There are just too many eFAST cases to choose from. Which one to tell you…? Should I talk about my first eFAST patient, the supposed-to-be-simple-but-really-wasn’t, coumadin guy who laid out his motorcycle? What about the lady from the rollover down a twenty foot embankment? Or the teenager from a horseback riding accident? Should I tell you about the night I hung out in resuscitation and did an eFAST on every patient that came through? A December night in medical school I like to think of as Ultrasound Christmas. A night when a trauma alert rolled in and before I knew what was happening, the resident put the ultrasound probe in my hand and said “Go for it!” Needless to say it was AWESOME! Like do-a-secret-happy-dance-in-the-hallway-afterwards kind of awesome. I definitely loved my ultrasound elective, especially once I became competent at eFASTs. So what’s an eFAST you ask? It’s simple really. It’s a systematic ultrasound scan to check for pneumothorax and free fluid (usually blood) in the abdomen and chest. It’s quick, easy, and incredibly useful. You don’t have to be a genius for this stuff. My first year med students can do this and so can you! If you’re going to spend time in the Emergency Department or with critically ill patients, you should learn the eFAST. End of story. So now that you’re convinced… just how do you do an eFAST?
The eFAST is a fast (pun intended) and easy way to check for blood in the chest and abdomen. Continue reading Life in the eFAST Lane: Sonography for Trauma (Part 1)
SonoQuizzes are a quick and easy way to test your ultrasound knowledge! They’re just for fun, but are a great way to see where you stand and what areas you can improve on. Plus, they go great with the FOAMed Curriculum modules to assess your learning. So give a quiz a try and see how you do!
Introduction to Ultrasound Quiz
More quizzes are on the way!
Generally, I like to write about positive ultrasound cases. This is not one of those cases. But out of this sad case there was much learning to be had for this med student. At the time of the case, I was on an emergency ultrasound elective. And I couldn’t have be happier! I was learning all sorts of awesome and useful skills. Another perk of being on ultrasound duty was that I got to tag along on all the ultrasound cases I can get my hands on, including the traumas (a big perk in my book). As soon as I heard a trauma called in, I gowned up, gloved up, goggled up, and masked up. I observed the FAST exam (Focused Abdominal Scan for Trauma) and helped however I was instructed. Mostly squeezing IV bags or fetching things, but I was in there; I had a job; and I was learning ultrasound awesomeness. Life was good…. like really, really good. Until it wasn’t. Enter a teenager in an ATV accident. One paramedic cranks out compressions, while the other relays patient information. Car versus ATV. Trouble intubating. And he’s asystolic. Huge bummer. This is not going to be fun and someone somewhere is going to be very sad tonight. Everyone is hustling. I stand at the foot of the bed squeezing fluids into the kid while lines are placed, drugs are pushed, and they figure out what’s wrong. I watch the FAST exam. Looks negative to me, so no visible blood in the pelvis, abdomen, or around the heart. Unfortunately the ultrasound’s heart view also shows no heart movement. There is no electrical activity on the ECG. He’s been down for a long time. Time of death is called. Everyone puts down what they were doing and steps away. I feel heavy. After the room has cleared, the ultrasound attending pulls the ultrasound up to the bedside. There is a valuable teaching opportunity here. He does another FAST exam, explaining it as he goes. Still no free fluid in the pelvis, abdomen, or pericardium. He puts the probe on his chest. No signs of pneumo or hemothorax. This is weird; an ATV versus car with no major bleeding from the neck down. I’m supposed to be learning what an ultrasound exam looks like on a trauma patient, but so far it all looks pretty normal. That’s odd… so what killed this kid? The ultrasound attending agrees it’s unusual and wants to check one more thing. Here’s where things get interesting. The only visible trauma is from the neck up; some bleeding from the ears, eyes, and an open scalp lac. With no helmet that really isn’t a surprise. What is a surprise is the ultrasound attending putting the ultrasound probe on his eye. What are we suppose to tell from this..? Intracranial pressure. Mind blow. Now I’m pretty sure the ultrasound attending is a wizard. On the screen, we see a normal globe with a huge optic nerve and sheath exiting. Before he even measures it, he can tell it’s too big. He measures it and confirms ICP is elevated. So how’d he do this?
In a Nutshell
Are you a medical student or physician trying to incorporate ultrasound in your clinical education? Is your clinical environment not so ultrasound friendly? SonoMojo’s got you covered. Check out our Vimeo post on “Learning Ultrasound in Ultrasound Naïve Environments“. It covers strategies for introducing ultrasound to the conversation, positively influencing patient care & hospital ultrasound culture, and creating your own ultrasound education in the absence of a formal ultrasound curriculum. Enjoy the post and happy ultrasounding!
Learning Ultrasound in Ultrasound Naive Learning Environments from SonoMojo on Vimeo.
SonoMojo is a guide to ultrasound education. It’s a place for the new-to-ultrasound to get started in bedside ultrasound education and for the ultrasound-pro to discover new ultrasound resources. We’ve collected the best of FOAMed ultrasound education in one place. We’ve also added a few of our own SonoMojo ultrasound resources to help you on your path to become an ultrasound master.
Be sure to check out these SonoMojo features:
Please enjoy the site! Happy ultrasounding!