From FAST to E-FAST: an overview of the evolution of ultrasound-based traumatic injury assessment

Montoya, Juan; Stawicki, Stanislaw P; Evans, David C.; Bahner, David P.; Sparks, Scott E.; Sharpe, Richard P; Cipolla, James

doi:10.1007/s00068-015-0512-1

Cited by 116 publications

(87 citation statements)

References 75 publications

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“…Over the last decades, the role of ultrasound has been integrated into different surgical clinical settings. Ultrasound is a vital diagnostic and interventional modality in trauma, surgical oncology, critical care, breast, pediatrics, endocrine, and vascular surgery [3,9,13–15,19–21]. More recently it has also been incorporated into minimally invasive surgery and in endoscopic exams [22,23].…”

Section: Discussionmentioning

confidence: 99%

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Nassour

Spalding

Hynan

et al. 2017

Journal of Surgical Research

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Background Despite the development of ultrasound courses by the American College of Surgeons two decades ago, many residencies lack formal ultrasound training. The aim of this study was to assess the previous ultrasound experience of residents and the efficacy of a new ultrasound curriculum by comparing pre- and post-course tests. Methods A pre-course survey and test were sent to all residents at the University of Texas Southwestern Medical Center. Pre-interns and junior residents received a didactic lecture on ultrasound basics and the extended focused assessment with sonography for trauma (EFAST) and were given hands-on practice. Finally, a post-course test and survey were sent to the pre-interns and junior residents. Results Only 11.3% of the residents reported having previous exposure to a formal ultrasound curriculum, and only 12.7% were taught by faculty. On the pre-course test, there was no difference in performance among senior residents, junior residents and pre-interns (p = 0.114). After taking the course, the pre-interns improved their performance and their average increased from 44.3% (SD = 12.4%) to 66.1% (SD = 12.2%; p < 0.001). The junior residents also had an improvement in their performance on the test after the course (p < 0.001). Junior residents performed better than pre-interns on the post-course test (p = 0.001). Conclusion The knowledge of surgical residents in ultrasound basics and EFAST can be improved with the establishment of an ultrasound curriculum. We believe that such an educational endeavor should be encouraged by all surgical residencies.

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Section: Discussionmentioning

confidence: 99%

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Nassour

Spalding

Hynan

et al. 2017

Journal of Surgical Research

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“…Whenever possible, cardiac US should be performed with a phased (or sector)-array transducer, which has a small surface footprint (approximately 20 Â 15mm) and relatively lower frequencies (2)(3)(4)(5)(6)(7)(8) to allow greater penetration into the thoracic cavity. 30 The footprint and frequency enable imaging between the ribs, but with a wide imaging sector.…”

Section: Probe Selectionmentioning

confidence: 99%

Focused Cardiac Ultrasound for the Regional Anesthesiologist and Pain Specialist

Haskins

Tanaka

Boublik

et al. 2017

Regional Anesthesia and Pain Medicine

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This article in our point-of-care ultrasound (PoCUS) series discusses the benefits of focused cardiac ultrasound (FoCUS) for the regional anesthesiologist and pain specialist. Focused cardiac US is an important tool for all anesthesiologists assessing patients with critical conditions such as shock and cardiac arrest. However, given that ultrasound-guided regional anesthesia is emerging as the new standard of care, there is an expanding role for ultrasound in the perioperative setting for regional anesthesiologists to help improve patient assessment and management. In addition to providing valuable insight into cardiac physiology (preload, afterload, and myocardial contractility), FoCUS can also be used either to assess patients at risk of complications related to regional anesthetic technique or to improve management of patients undergoing regional anesthesia care. Preoperatively, FoCUS can be used to assess patients for significant valvular disease, such as severe aortic stenosis or derangements in volume status before induction of neuraxial anesthesia. Intraoperatively, FoCUS can help differentiate among complications related to regional anesthesia, including high spinal or local anesthetic toxicity resulting in hemodynamic instability or cardiac arrest. Postoperatively, FoCUS can help diagnose and manage common yet life-threatening complications such as pulmonary embolism or derangements in volume status. In this article, we introduce to the regional anesthesiologist interested in learning FoCUS the basic views (subcostal 4-chamber, subcostal inferior vena cava, parasternal short axis, parasternal long axis, and apical 4-chamber), as well as the relevant sonoanatomy. We will also use the I-AIM (Indication, Acquisition, Interpretation, and Medical decision making) framework to describe the clinical circumstances where FoCUS can help identify and manage obvious pathology relevant to the regional anesthesiologist and pain specialist, specifically severe aortic stenosis, hypovolemia, local anesthetic systemic toxicity, and massive pulmonary embolism.

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“…The natural evolution toward the extended FAST (E-FAST) has spread its use to the evaluation of chest injuries [4,5] and thereafter, more broadly, in the evaluation and management of trauma patients [6,7].…”

Section: Introductionmentioning

confidence: 99%

Management of Post-Traumatic Complications by Interventional Ultrasound: a Review

2016

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Purpose of Review We reviewed the current literature to assess the feasibility of ultrasound-assisted and ultrasoundguided procedures for the treatment of post-traumatic complications and to address the indications and techniques of procedures. Recent Findings Non-operative strategies have been introduced in the treatment of severe trauma, and consequently, the incidence of some post-traumatic complications has increased. US can be useful both for the initial assessment of trauma patients and for the treatment of complications. Summary Ultrasound-guided and ultrasound-assisted procedures as a therapeutic tool in the management of post-trauma settings are probably underused, in comparison with their successful use in other acute settings. Some new possible fields of clinical researches are suggested.

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From FAST to E-FAST: an overview of the evolution of ultrasound-based traumatic injury assessment

Cited by 116 publications

References 75 publications

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

The surgeon-performed ultrasound: a curriculum to improve residents’ basic ultrasound knowledge

Focused Cardiac Ultrasound for the Regional Anesthesiologist and Pain Specialist

Management of Post-Traumatic Complications by Interventional Ultrasound: a Review

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