Advanced Trauma Life Support ATLS Student Course Manual 2018

366
APPENDIX G n Skills
n FIGURE G-2
n FIGURE G-3
n FIGURE G-4
STEP 3. Scan the left upper quadrant. Position
the probe marker toward the head in the
coronal plane (n FIGURE G-3). Begin scan
more cephalad than on the right and more
posterior. Begin in the midaxillary line.
Rotate the probe obliquely and visualize
the diaphragm, spleen, and kidney.
STEP 4: (Ideally, the bladder is full.) Place the probe
above the pubic bone with the probe marker
pointing to the right (n FIGURE G-4). Scan
for fluid, which appears as a dark stripe.
Rotate the probe 90 degrees so the probe
marker points to the head (n FIGURE G-5). Scan
for fluid.
Perform an eFAst exam
ANd DemonstRAte Proper
pRobe Positioning
STEP 1. Place the probe in the second or third
intercostal space in the mid clavicular line in
n FIGURE G-5
a sagittal orientation (n FIGURE G-6), and slide
the probe caudally (n FIGURE G-7). Examine 2
or 3 interspaces. Including more interspaces
increases the sensitivity
STEP 2. Evaluate the right and left diaphragms using
the same probe position as for evaluation
of the perihepatic and perisplenic space
(n FIGURE G-8), sliding the probe one rib space
cephalad (n FIGURE G-9).
STEP 1.
Identify Abnormal eFAst
on Still or Video Images
Look for lung sliding. If you see none, look
for lung pulse.
STEP 2. Look for comet tails.
STEP 3. Look for seashore, bar code, or stratosphere
sign in M mode. Bar code and stratosphere
signs indicate pneumothorax.
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