Not so FAST – Episode 5

Not so FAST &#8211; Episode 5 Should we be doing FAST exams on all pediatric trauma patients? In this episode, we hear about a case where the FAST may have saved a child’s life. Then we talk with peds trauma experts, Drs. Nate Kuppermann and Jim Holmes, about their recent study on the utility of the FAST exam in stable pediatric trauma patients. Ultrasound expert, Ken Kelley, shares his thoughts on the paper and the role of the FAST exam in kids. Do you FAST all of your pediatric trauma patients? Join the conversation on social media @empulsepodcast or at ucdavisem.com. Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest Host: Dr. Michael Schick, Assistant Professor of Emergency Medicine and Global Ultrasound Fellowship Director at UC Davis Guests: Dr. Nate Kuppermann, Professor and Chair of the Department of Emergency Medicine at UC Davis, Founding Chair of the PECARN Steering Committee Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis, SAEM Secretary-Treasurer Dr. Ken Kelley, Associate Professor of Emergency Medicine and Ultrasound Fellowship Director at UC Davis Case retold by Dr. Nathan Vanden Berge, Emergency Medicine Resident at UC Davis Resources: Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial. Holmes JF, Kelley KM, Wootton-Gorges SL, Utter GH, Abramson LP, Rose JS, Tancredi DJ, Kuppermann N. JAMA. 2017 Jun 13;317(22):2290-2296. doi: 10.1001/jama.2017.6322. PMID: 28609532 Use of the focused assessment with sonography for trauma (FAST) examination and its impact on abdominal computed tomography use in hemodynamically stable children with blunt torso trauma. Menaker J, Blumberg S, Wisner DH, Dayan PS, Tunik M, Garcia M, Mahajan P, Page K, Monroe D, Borgialli D, Kuppermann N, Holmes JF; Intra-abdominal Injury Study Group of the Pediatric Emergency Care Applied Research Network (PECARN). J Trauma Acute Care Surg. 2014 Sep;77(3):427-32. doi: 10.1097/TA.0000000000000296. PMID: 25159246 Sonostuff.com FAST in Trauma Part 1 Video FAST in Trauma Part 2 Video SAEM: FAST examination ACEP Pediatric Emergency Ultrasound Update: The Unique Pediatric FAST Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. <img width="150" height="150" src="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?resize=150%2C150&#38;ssl=1" class="attachment-thumbnail size-thumbnail" alt="" decoding="async" loading="lazy" srcset="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?resize=150%2C150&#38;ssl=1 150w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?resize=50%2C50&#38;ssl=1 50w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?zoom=2&#38;resize=150%2C150&#38;ssl=1 300w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?zoom=3&#38;resize=150%2C150&#38;ssl=1 450w" sizes="auto, (max-width: 150px) 100vw, 150px" data-attachment-id="1381" data-permalink="https://ucdavisem.com/2018/04/16/not-so-fast-episode-5/img_1502/" data-orig-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?fit=1286%2C860&#38;ssl=1" data-orig-size="1286,860" data-comments-opened="1" data-image-title="Dr. Sarah Medeiros" data-image-description="" data-image-caption="&#60;p&#62;Dr. Sarah Medeiros&#60;/p&#62; " data-large-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1502.jpg?fit=1024%2C685&#38;ssl=1" /> <img width="150" height="150" src="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?resize=150%2C150&#38;ssl=1" class="attachment-thumbnail size-thumbnail" alt="" decoding="async" loading="lazy" srcset="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?resize=150%2C150&#38;ssl=1 150w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?resize=50%2C50&#38;ssl=1 50w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?zoom=2&#38;resize=150%2C150&#38;ssl=1 300w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?zoom=3&#38;resize=150%2C150&#38;ssl=1 450w" sizes="auto, (max-width: 150px) 100vw, 150px" data-attachment-id="1382" data-permalink="https://ucdavisem.com/2018/04/16/not-so-fast-episode-5/img_1509/" data-orig-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?fit=1776%2C1184&#38;ssl=1" data-orig-size="1776,1184" data-comments-opened="1" data-image-title="IMG_1509" data-image-description="" data-image-caption="&#60;p&#62;Recording EM Pulse&#60;/p&#62; " data-large-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1509.jpg?fit=1024%2C683&#38;ssl=1" /> <img width="150" height="150" src="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?resize=150%2C150&#38;ssl=1" class="attachment-thumbnail size-thumbnail" alt="" decoding="async" loading="lazy" srcset="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?resize=150%2C150&#38;ssl=1 150w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?resize=50%2C50&#38;ssl=1 50w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?zoom=2&#38;resize=150%2C150&#38;ssl=1 300w, https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?zoom=3&#38;resize=150%2C150&#38;ssl=1 450w" sizes="auto, (max-width: 150px) 100vw, 150px" data-attachment-id="1383" data-permalink="https://ucdavisem.com/2018/04/16/not-so-fast-episode-5/img_1511/" data-orig-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?fit=1639%2C1091&#38;ssl=1" data-orig-size="1639,1091" data-comments-opened="1" data-image-title="IMG_1511" data-image-description="" data-image-caption="&#60;p&#62;Dr. Julia Magana&#60;/p&#62; " data-large-file="https://i0.wp.com/ucdavisem.com/wp-content/uploads/2018/04/IMG_1511.jpg?fit=1024%2C682&#38;ssl=1" /> &#160; The FAST exam from the case in this episode reveals a massive hemopericardium with tamponade, shown here in the subxiphoid view.