fast dpl ct
Transcript of fast dpl ct
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Indications:
- Equivocal physical
examination- Unexplained shock or
hypotension
- Altered sensorium(closed head injury,drugs, etc.)
- General anesthesia for
extra-
abdominalprocedures
- Cord injury
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Contraindications :
Clear indication forexploratory
laparotomy
Relative
contraindications:
- Previous exploratory
laparotomy
- Pregnancy
- Obesity
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Focused Assessment with Sonography for
Trauma (FAST)
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FAST:Strengths
Rapid (~2 mins) Portable
Inexpensive
Technically simple, easy totrain (studies show
competence can be achievedafter ~30 studies)
Can be performed serially
Useful for guiding triagedecisions in trauma patients
Limitations
Does not typically identify source of
bleeding, or detect injuries that do notcause hemoperitoneum
Requires extensive training to assessparenchyma reliably
Limited in detecting
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Indications Blunt trauma
Hemodynamic stability
Normal or unreliable physical
examination Mechanism: Duodenal and
pancreatic trauma
Contraindications Clear indication for
exploratory laparotomy
Hemodynamic instability
Agitation
Allergy to contrast media5
Advantages
Adequate assessment of theretroperitoneum
Nonoperative management of solid
organ injuries Assessment of renal perfusion
Noninvasive
High specificity
Disadvantages Specialized personnel
Hardware
Duration: Helical versusconventional
Hollow viscus injuries
Cost
CT SCAN Hemodynamically stable patient The patient should be in a transportable condition Triple contrast CT is the preferred mode
IV +O
RAL + RECTAL
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CT FAST DPL
Accuracy 96% 95-99% 95%Sensitivity 97% 90-92% 100%
Specificity 95% 88-90% 85%
Drawback Stable pts
only
Cannot evaluate
retroperitoneum. Cannot
identify source of fluid.
0.5% miss intestinal
perforation; cannotdistinguish blood vs
bowel contents