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FOR THE LOVE OF POCUS
Positive FAST Pelvis - Transverse
Blunt trauma patient with POSITIVE FAST scan. The uterus can been seen floating in free fluid.
Dr. Justin Bowra
Positive FAST - Pelvis Transverse
Blunt trauma patient with POSITIVE FAST scan. Free fluid can be seen posterior and lateral to the bladder in this sagittal view.
Dr. Justin Bowra
Positive FAST - Pelvis
30 y/o pedestrian struck by car, hemodynamically unstable, tachycardic. FAST performed after primary survey revealed free fluid in all four abdominal views of the FAST exam.
Free fluid seen superior and posterior to the bladder in this sagittal view.
Dr. Catharine Bon - Kings County Emergency Medicine
Free Fluid within Abdomen
A 35-year-old woman presented to the ED after experiencing blunt abdominal trauma. She was hemodynamically unable. E-FAST Exam performed at bedside was notable for free intra-abdominal fluid (viewed here from suprapubic region). This rapid diagnosis enabled prompt disposition to the operating room.
Josiane Almeida, Emergency Physician; Sao Paulo- Brazil
Positive FAST - Pelvis - Sagittal
Blunt trauma patient with POSITIVE FAST scan. Free fluid can be seen posterior to the dome of bladder in this sagittal view.
Dr. Justin Bowra
Free Peritoneal Fluid from Splenic Injury
20s M presented with abdominal and back pain several hours after a fall off a ladder, and on FAST exam, had a large amount of free fluid seen in the pelvis/lower abdomen and in the RUQ. He was slightly tachycardic but normotensive, so underwent CT of the abdomen/pelvis, which demonstrated a significant spleen injury which was managed by IR embolization.
Dr. Greg Wiener, PGY3
Denver Health Residency in Emergency Medicine
Pelvic +FAST from Spleen Lac
20s F presented with presyncopal episode after standing electric scooter crash. She had been evaluated at an urgent care where she had dental injuries identified, but was initially hemodynamically stable. She arrived to the ED tachycardic and hypotensive, and FAST exam was positive in the pelvic view as shown here in transverse and sagittal orientations. She was resuscitated with massive transfusion protocol and responded well. CT scanning showed a grade 2 splenic laceration. The patient was admitted for further observation and serial CBC checks.
Dr. Larry Benjey, PGY-3
Denver Health Residency in Emergency Medicine
Pelvic +FAST from Splenic Injury
A teenage male patient presented to the ED after a helmeted mountain bike crash, and due to mechanism, underwent a bedside FAST exam, which was positive in the RUQ as well as suprapubic views. CT demonstrated a grade 4 spleen laceration as well as multiple buckle rib fractures, and he was admitted for observation.
Dr. Gabe Siegel, PGY-2 and Dr. Michael Kidon, PGY-4
Denver Health Residency in Emergency Medicine
Suprapubic +FAST from GSW
20s M presented as a walk in after sustaining a GSW to the hip. He was initially hemodynamically unstable, however responded well to transfusion of blood products and vitals normalized. FAST exam of the suprapubic/pelvic area is shown here, with heterogenous free fluid seen best in the sagittal view. FAST was also positive in the RUQ and LUQ. Plain films demonstrated a retained missile in the abdomen. As he was hemodynamically stable, CT of the abdomen and pelvis was obtained, showing hemoperitoneum and free air concerning for bowel and vascular injury. The patient was taken emergently to the OR, where exploratory laparotomy demonstrated a pelvic hematoma and hemoperitoneum from an iliac vein injury, as well as multiple areas of small bowel injury. His injuries were repaired, he recovered well, and was discharged within days of his injury.
Dr. Ian Eisenhauer, PGY1
Denver Health Residency in Emergency Medicine