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VetVine Client Care
GLOBAL FAST Ultrasound: Pearls Of Wisdom
Emergency & Critical Care
Melissa Holahan, DVM, DACVECC - a veterinary emergency and critical care specialist - shared these takeaways from a webinar she attended that was presented by Gregory R. Lisciandro, DVM, DACVECC:
Global FAST Ultrasound, which is the combination of AFAST, TFAST and Vet BLUE imaging techniques can be a very quick and useful tool in assessing volume status of your patient.
*Shaving your patient is not necessary
*Ambient lighting is adequate for Global FAST ultrasound (i.e. no need to dim the lights)
*With training and practice anyone can master these techniques (start doing them on all of your patients so that you can get used to understanding what "normal" looks like, and can better recognize "abnormal")
Preferred position for Global FAST ultrasound = RIGHT LATERAL RECUMBENCY then STERNAL / STANDING (Vet BLUE) - Why? because this provides the best windows for cardiac imaging and the least amount of lung interference
DH view in lateral or sternal / standing position can be one of the most informative views
- Evaluate heart for pericardial effusion ("race track" sign)
- Evaluate caudal vena cava (CVC) for distention (flat = volume deplete vs. fat with hepatic trees = volume overload / venous congestion)
- Evaluate dogs for the gallbladder "halo" sign - while previously thought to only be associated with anaphylaxis in dogs - it can also be a sign of right-sided heart conditions (i.e. pericardial effusion, PTE, volume overload, etc.). Therefore it's very important to look at your caudal vena cava as well from the DH view to support volume status (example = flat CVC with a gall bladder halo sign would likely support anaphylaxis as compared to a fat CVC with a gall bladder halo sign that would more likely be associated with R-sided heart disease).
Lastly, the abdominal fluid score (AFS) should be an integral part of the clinical assessment of our patients (esp. trauma patients). Recent studies have shown that an AFS of 1 or 2 on initial exam will likely not be at high risk for becoming anemic vs an AFS of 3 or 4, which correlates with a risk of significant hemorrhage, anemia, and the need for transfusion therapy.
For more information visit fastvet.com