Feasibility of FAST examination performance with ultrasound contrast

Michael Blaivas, Matthew L Lyon, Larry Brannam, Richard B Schwartz, Sandeep Duggal

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

The Focused Abdominal Sonography in Trauma (FAST) examination has several limitations, among which is the inability to reliably detect solid organ injury. We sought to evaluate the feasibility of ultrasound contrast use during a FAST examination and its effect on the ability to delineate vasculature in the spleen and liver from hilum to capsule on simulated patients. This prospective observational case control study was conducted at an urban community hospital Emergency Department (ED) that is a level I trauma facility. During a FAST examination, the liver and spleen were scanned in entirety to evaluate contrast opacification of blood vessels and a latent phase highlighting the parenchyma of the liver and spleen. Each physician, hospital credentialed for the use of emergency ultrasound, scanned the liver and spleen both before and after contrast administration. Five milliliters of contrast were mixed with 16 mL of normal saline and then injected 4 mL at a time through an 18-gauge anticubital catheter. All examinations were successfully completed before contrast agent dissipation. The mean time to complete the FAST examination with interrogation of the liver and spleen was 1 min 42 s (range 1 min 22 s to 2 min 5 s). The mean time to initial visualization of contrast was 15 s (range 12 to 18 s). The latent phase of the ultrasound contrast when the liver or spleen began to shimmer, an effect that would outline hematomas not actively bleeding, occurred at a mean time of 54 s (range 45 s to 1 min 9 s). The ultrasound contrast disappeared at a mean of 2 min 52 s (range of 2 min 16 s to 3 min 33 s). In conclusion, ultrasound contrast use is feasible during the FAST examination and allows enhanced evaluation of solid organ parenchyma during evaluation for solid organ injury.

Original languageEnglish (US)
Pages (from-to)307-311
Number of pages5
JournalJournal of Emergency Medicine
Volume29
Issue number3
DOIs
StatePublished - Oct 1 2005

Fingerprint

Ultrasonography
Spleen
Wounds and Injuries
Liver
Urban Hospitals
Hospital Departments
Community Hospital
Hematoma
Contrast Media
Capsules
Blood Vessels
Case-Control Studies
Hospital Emergency Service
Emergencies
Catheters
Hemorrhage
Physicians

Keywords

  • Blunt abdominal trauma
  • Emergency medicine
  • Emergency ultrasound
  • Solid organ injury
  • Trauma ultrasound
  • Ultrasound contrast

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Feasibility of FAST examination performance with ultrasound contrast. / Blaivas, Michael; Lyon, Matthew L; Brannam, Larry; Schwartz, Richard B; Duggal, Sandeep.

In: Journal of Emergency Medicine, Vol. 29, No. 3, 01.10.2005, p. 307-311.

Research output: Contribution to journalArticle

Blaivas, Michael ; Lyon, Matthew L ; Brannam, Larry ; Schwartz, Richard B ; Duggal, Sandeep. / Feasibility of FAST examination performance with ultrasound contrast. In: Journal of Emergency Medicine. 2005 ; Vol. 29, No. 3. pp. 307-311.
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