Today's Veterinary Practice

NOV-DEC 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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todaysveterinarypractice.com NOVEMBER/DECEMBER 2018 57 INSIGHTS CLINICAL CLINICAL INSIGHTS AFAST and TFAST (abdominal and thoracic focused assessment with sonography for trauma, triage, and tracking) constitute limited ultrasound examinations that focus on identifying the presence of fluid within the peritoneal, pleural, and pericardial spaces. Examination findings are used to direct immediate patient stabilization efforts, and serial studies can be used to monitor hospitalized patients. In the emergency setting, focused ultrasound examinations are increasingly being used as extensions of the physical examination, and thorough descriptions of these examinations have been published. 1–4 This article provides an introduction to performing and interpreting the AFAST and TFAST examinations. AFAST and TFAST are not intended to be comprehensive examinations. They are subject to numerous technical limitations, including the operator's skill level, the quality of available equipment, and the fact that they are often performed in suboptimal conditions (e.g., stressed patient, loud room, bright ambient lighting). Despite these limitations, adhering to a consistent protocol should help to maximize the diagnostic yield. PATIENT PREPARATION, POSITIONING, AND SCAN FACTORS Patient stability at the time of presentation to the emergency service may determine scan position and the extent of patient preparation. Generally, the patient is not shaved for the examination, unless ultrasound-guided sampling or other interventions are performed. If the patient has a very long or thick coat, shaving will be necessary. Isopropyl alcohol and/or acoustic coupling gel should be used. Lateral recumbency is preferred, and there is no difference in free fluid detection rates between patients positioned in left or right lateral recumbency. 5 The right kidney will be more difficult to visualize when located in the dependent flank (i.e., patient in right lateral recumbency), so scanning in left lateral recumbency has been shown to be faster. 5 Sonography Assessment: Overview of AFAST and TFAST Philip E. Hamel, DVM, Clifford R. Berry, DVM, DACVR College of Veterinary Medicine University of Florida IMAGING ESSENTIALS Welcome to our series of articles on small animal abdominal ultrasonography. The initial articles provided an overview of basic ultrasonography principles and a discussion about how to perform a systematic scan of the abdomen. The rest of the series discusses ultrasound evaluation of specific abdominal organs/systems. Read the other small animal abdominal ultrasonography articles published in Today's Veterinary Practice at todaysveterinarypractice.com .

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