e-FAST - Pneumothorax

We've talked about FAST...now we need to put the "E" into it. The E wasn't taught to me in my course, and isn't mentioned on the college e-learning module, but it is on their checklist to be assessed for competence...

How
- Ideally you need a linear probe
- Place the probe in the 2nd or 3rd IC space, midclavicular line, and slide caudally.
Bat Sign - the top rib looks like a bat flying out of the screen
- Then look in the 6th IC space, ant axillary line


Normal
Comet Tails - artifacts from the pleural line. Sliding lung and comet tails are normal.
Seashore Sign or waves on a sandy beach- normal lung sliding on M mode.
 - from http://www.intechopen.com/books/hot-topics-in-echocardiography/lung-ultrasound-comet-tails-technique-and-clinical-significance

  - from https://sonospot.wordpress.com/2012/06/19/sonoapp-lung-ultrasound-the-down-low-of-pneumo-with-the-help-of-lichtenstein-of-course/


Pneumothorax
Loss of pleural sliding/ loss of the seashore sign in a spontaneously breathing patient.
This leads to the stratosphere or bar code sign.
No comet tails
 - from https://sonospot.wordpress.com/2012/06/19/sonoapp-lung-ultrasound-the-down-low-of-pneumo-with-the-help-of-lichtenstein-of-course/

References
https://www.acep.org/Clinical---Practice-Management/Focus-On--EFAST---Extended-Focused-Assessment-With-Sonography-for-Trauma/
https://www.youtube.com/watch?v=Yg78aU93SZE
https://www.youtube.com/watch?v=EVQTI7ivhFM
https://sonospot.wordpress.com/2012/06/19/sonoapp-lung-ultrasound-the-down-low-of-pneumo-with-the-help-of-lichtenstein-of-course/