Patient with stab injury to the lower chest presented with low pulses and BP improved after giving IV fluids. Chest X-ray showed clear lung fields. Next step in the management:
STAB INJURY- we will go for E-FAST (extended focused assessment with sonography for trauma), non invasive,can easily assess thorax, can easily differentiate whether there is contusion or presence of blood FAST (Focused Assessment with Sonography for Trauma)- It is an Emergency ultra sound i.e. performed very fast - Assess Potential sites of thoracoabdominal injuries(4P's) - Pericardial sac- Perihepatic region- Peri-splenic region- Pelvis- 4 traditional views in FAST e-FAST (extended FAST)- Has two additional views (so, has a total of 6 views)- Right thoracic view- Left thoracic view- Pneumothorax on e-FAST shows bar code sign / stratosphere sign
Chest tube inseion
CECT abdomen
CECT chest
E- fast
NEET Jan 2020