Albany Medical Center
Department of Emergency Medicine
Ultrasound Division

Topics

FAST Exam

Objectives

• 1. Describe the clinical indications for the exam.
  

• 2. Describe image acquisition and understand the importance of being in the correct window.
  

• 3. List the sonographic windows and discuss their ordering.
  

• 4. Understand patterns of free fluid movement in the abdomen.
  

• 5. Discuss normal sonographic findings such as epicardial fat pad, colon, the IVC, gallbladder, perinephric fat, stomach and seminal vesicles. Focus on evaluating for peristalsis, echogenic borders surrounding fluid, the importance of being in the correct window, and using color doppler as an aid in discerning vascular structures.
  

• 6. Discuss abnormal findings:
  

• • a. Sonographic findings associated with hemoperitoneum in each window.
    

  • b. Subcostal and parasternal views being used together to discern pericardial effusions.
    

  • c. Examination techniques for discerning hemothorax.
    

• 7. Discuss exam limitations such as fluid estimation and solid organ injury.
  

• 8. Discuss the pitfalls associated with the various views and why understanding normal sonographic findings is critical.
  

Hands on Experience

Start to obtain good hand control. Get used to staying centered on an object. Trace blood vessels and get comfortable switching from long to short axis while keeping the object in constant view. Play with the features on the sonosite.

Easy scans , may be obtained with poor technique while hard scans will never be obtained with poor technique.

Quiz

Take the ACEP Ultrasound FAST quiz and bring a printout of the results to the meeting.