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FAST for Hemorrhage from Pelvic Fracture

Should we talk about REBOA?

By Michael Prats, MD on 12/10/18 06:00 AM

The FAST exam is tried and true for trauma, but in the past it hasn't been super useful for patients with isolated pelvic fractures. This study teases out a very sick subset of this population - patient who have significant hemorrhage associated with their fracture. The question is how well can the FAST identify intraabdominal hemorrhage in these people. The authors' idea is that if the FAST can find intraperitoneal blood, it might help determine who would benefit from REBOA instead of laparotomy.


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Speckle Tracking for Acute Coronary Syndrome

Feasibility and Accuracy in the ED

By Michael Prats, MD on 11/26/18 06:00 AM

Speckle tracking? Is that the technology that the government uses to mine data from your phone?! No - totally different! This is an ultrasound technology that recognizes tiny specks in the myocardium, allowing for a measurement of the movement of the heart wall. This has the potential to quantify the contractility of different parts of the heart, and therefore can be used to help diagnose numerous cardiac pathologies. At this time, not many people are using this in the emergency department. This is the first study to take a look to see if this is feasible and if it is accurate in diagnosing patients with acute coronary syndrome.


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Small Bowel Obstruction

The Poo and the Fro

By Michael Prats, MD on 11/12/18 06:00 AM

Ultrasound was made for the diagnosis of small bowel obstruction. It loves when air filled things are turned into fluid filled things - its helps us see it better. When the bowel gets backed up and distends with digested cheeseburgers, ultrasound is there to save the day. As easy as this may seem, it has not been well studied. There are a few small studies that show it can be accurate compared to a CT, but without a large body of evidence - a lot of people are (quite reasonably) unwilling to put their faith in it. Well, we can't say this study is going to turn all that around, but its one more piece of the puzzle of figuring out how we can use POCUS for this diagnosis.


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