Pratica di Shadowing: FAST Exam: Focused Assessment with Sonography in Trauma - Impara a parlare inglese con i video
Creazione lezione...
1
Hello, everyone.
2
My name is Dr. Aidan Sharkey.
3
I'm an attending anesthesiologist at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, and today we're going to be discussing the FAST exam.
4
The key takeaways of today's lecture are to firstly discuss the indications and limitations of performing the FAST exam, secondly to discuss the equipment required,
5
and finally we'll go through some basic views involved in performing the FAST exam.
6
To begin let us first define what exactly a FAST exam is.
7
FAST stands for Focus Assessment with Sonography and Trauma
8
and this is a rapid assessment done at the bedside for trauma patients in order to diagnose and guide therapy.
9
With the FAST exam we are assessing for free fluid which would indicate visceral injury in four key regions,
10
peri -hepatic, perisplenic, pericardium, and suprapubic areas.
11
The indications for performing a FAST exam are very broad, and its use should be considered in all abdominal and or thoracic trauma situations,
12
where the mechanism of injury is blunt or penetrating in nature.
13
Patients presenting with undifferentiated hypotension or shock should also undergo a FAST exam as part of their workup.
14
With respect to the limitations of performing a FAST exam, there are no absolute contraindications.
15
However, the exam should not delay treatment of unstable patients, and the operator should be aware of the limited sensitivity of a negative exam.
16
Therefore, an unstable patient with a negative FAST exam or a patient in
17
which there is a high index of suspicion for visceral injury
18
should undergo further testing in the form of a CT scan or operative assessment.
19
In terms of equipment required for performing a FAST exam, you will need access to an ultrasound machine and the correct ultrasound probe.
20
For abdominal scans, we generally choose the curvilinear probe, which is a probe with a low frequency resulting in increased depth of penetration.
21
Alternatively, the phased array probe, which is also a low frequency probe, can also be utilized as part of the FAST exam.
22
It is important to note the location of the indicator marker on the probe
23
and which side of the image this corresponds to when looking at the screen.
24
For the curvilinear probe, this is generally on the left of the screen.
25
And for the phased array probe, this is on the right of the screen.
26
Moving on to performing the FAST exam, and this is performed by examining four areas for the presence of free fluid.
27
that is the right upper quadrant for fluid in the peri
28
-hepatic space left upper quadrant for fluid in the perisplenic space subcostal area for pericardial fluid
29
and finally the pelvic area for suprapubic fluid we will now go through each of these views
30
and discuss how each view is obtained
31
and look at some sonoanatomy the right upper quadrant
32
or peri -hepatic view is used to assess for free fluid in the space between the liver and the right kidney.
33
To obtain this view, we place the probe in the mid -axillary line on the right side between the 8th
34
and 11th intercostal space.
35
The indicator should be facing towards the 12 o 'clock position or the patient's head.
36
This view is most useful for the assessment of free fluid in the peri -epatic space, also known as Morrison's pouch, as depicted in this image.
37
This example depicts fluid in the peri -hepatic space as indicated by the yellow arrows.
38
An image such as this is very concerning for a visceral injury.
39
Moving on to the left upper quadrant or perisplenic view.
40
This view is used to assess for free fluid around the left kidney and spleen.
41
To obtain this view we place the probe in the mid
42
-auxiliary line on the left side between the 8th to 11th
43
intercostal space with the indicator again facing towards the 12 o 'clock position or patient's head.
44
As anatomically the spleen is a very posterior structure, the probe will also need to be in a very posterior position in order to obtain this view.
45
In this view, the structures identified include the spleen to the left of the screen, the left kidney to the right of the screen, and the diaphragm to the bottom of the screen.
46
Sliding between intercostal spaces may again be required to optimize this view.
47
In this view, we are looking for free fluid accumulation in two spaces the perisplenic space between the spleen
48
and the diaphragm as indicated by the green line
49
and the splenorenal space between the spleen and the left kidney as indicated by the yellow line
50
free fluid will preferentially be located in the perisplenic space
51
or into the presence of the splenorenal ligament
52
which limits the ability of fluid to track in between the spleen
53
and the left kidney in this image we see free fluid as indicated by the yellow arrows surrounding the space.
54
To obtain the subcostal view, we place the probe just inferior to the xiphoid process.
55
If we are using the curvilinear probe, we have the indicator facing to the patient's right.
56
However, if we are using the phased array probe, we have the indicator facing to the patient's left.
57
It is often helpful to have the patient bend their knees and take a breath in to optimize this view.
58
And also the ultrasound probe should be aligned slightly anteriorly.
59
In this view, we should be able to identify the liver, pericardium, and the two atria and two ventricles of the heart as depicted in this video loop.
60
This view is particularly useful for evaluating for free fluid in the pericardial space, as seen in these videos depicted by the yellow arrows.
61
Both video clips demonstrate circumferential fluid collection.
62
The video to the right of the screen additionally depicts one of the distinguishing features suggesting possible tamponade physiology,
63
that is right ventricular diastolic collapse.
64
Finally, the pelvic scan will assess for fluid in the suprapubic region.
65
To obtain this view, we place the probe right above the pubic symphysis with the indicator probe facing to the patient's right.
66
Ideally, the patient would have a full bladder
67
so as to act as an acoustic window
68
and then the probe should be tilted caudally so as to scan deep into the pelvic cavity.
69
In this view, we should be able to identify the bladder, prostate and rectum in males and in females the bladder,
70
uterus and rectum should be seen. In males,
71
fluid tends to accumulate in the recto for cycle pouch whereas in females fluid collects in the recto uterine pouch
72
which is also known as the pouch of Douglas.
73
In this example, we can see free fluid accumulating in the recto uterine pouch, as indicated by the yellow arrows,
74
possibly indicating a ruptured ectopic pregnancy in this patient.
75
That concludes our lecture on the FAST exam today.
76
In summary, we went through the four basic U's to perform a FAST exam, along with highlighting both normal and abnormal anatomy associated with these views.
77
Thank you for watching, and I hope you found this topic helpful.
✨ Video consigliato
C11
53 frasi
FAST Scan (Focused Assessment with Sonography in Trauma) - STEP by STEP
Daily ConversationUniversity Students
C11
129 frasi
Focused Assessment With Sonography in Trauma (FAST)
Daily ConversationUniversity Students
C12
61 frasi
Abdominal Examination - OSCE Guide (Latest) | UKMLA | CPSA | PLAB 2
Daily ConversationUniversity Students
C194 frasi
Transient Thermal Analysis in ANSYS AIM
Daily ConversationUniversity StudentsWorking Adults
C14
50 frasi
Decompression alone versus decompression with instrumented fusion in the t | Kaiser | EUROSPINE 2025
Daily ConversationUniversity Students
C11
93 frasi
Introduction to ECMO Part 3 - V-A ECMO
Daily ConversationUniversity StudentsWorking Adults
B24
54 frasi
The FASTEST Way to Study Anything
Daily ConversationUniversity Students
C12
84 frasi
Heart Failure Medications: What to Monitor Before You Give Them (Video 4 of 5)
Daily ConversationUniversity Students
C11
109 frasi
Surgical Anatomy 2 (Spleen)
Daily ConversationUniversity Students
C11
91 frasi
How To: Ultrasound for Pneumothorax Case Study Video
Daily ConversationUniversity StudentsWorking Adults
C11
18 frasi
Abdominal Bracing
Daily ConversationUniversity Students
C15
29 frasi
SVINutes: VAN Score
Daily ConversationUniversity Students
Vocabolario e note di pronuncia per questa lezione
Questa lezione di conversazione si basa sul video “FAST Exam: Focused Assessment with Sonography in Trauma”. Le parole che ritornano più spesso: fluid, view, probe, exam, Fast. Questo video contiene 61 frasi e 1167 parole da ripetere con lo shadowing. Il parlato dura 7:28. Chi parla ha un ritmo naturale di circa 156 parole al minuto, vicino a una conversazione quotidiana. Solo il 72% delle parole rientra nelle 3.000 più comuni dell’inglese, quindi il lessico è impegnativo.
Vocaboli chiave di questo video
15 parole del video che vale la pena imparare, con pronuncia e significato:
| Parola | Pronuncia | Significato |
|---|---|---|
| fluid sostantivo | /ˈflu.ɪd/ | fluido |
| probe sostantivo | /pɹoʊb/ | sonda, specillo |
| examination sostantivo | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | esame, visita |
| indicate verbo | /ˈɪndɪˌkeɪt/ | indicare |
| obtain verbo | /əbˈteɪn/ | ottenere |
| kidney sostantivo | /ˈkɪdni/ | rene |
| assessment sostantivo | /əˈsɛsmənt/ | accertamento |
| arrow sostantivo | /ˈæɹəʊ/ | freccia |
| assess verbo | /əˈsɛs/ | valutare, stimare |
| scan verbo | /skæn/ | scrutare |
| trauma sostantivo | /ˈtɹɔm.ə/ | trauma |
| array sostantivo | /əˈɹeɪ/ | abbigliamento, agghindamento |
| bladder sostantivo | /ˈblædɚ/ | vescica |
| ultrasound sostantivo | /ʌl.tɹə.saʊnd/ | ultrasuono |
| helpful aggettivo | /ˈhɛlp.fl̩/ | disponibile, utile |
I phrasal verb che sentirai
| Parola | Significato |
|---|---|
| go through verbo | attraversare |
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | should be considered · be utilized · is performed |
| Frasi relative who / which + frase — un’informazione in più su una persona o una cosa | probe, which is |
Pronuncia a cui fare attenzione
Chi parla usa 3 contrazioni e forme ridotte, come I'm, we'll, we're. Pronunciale nella forma breve, così come le senti.
- I suoni “th”: breathe /bɹiːð/, thoracic /θəˈɹæsɪk/
- I suoni “sh” e “zh”: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, indication /ɪndɪˈkeɪʃən/, limitation /lɪmɪˈteɪʃən/, shock /ʃɔk/, associate /əˈsoʊʃi.ət/
- Parole lunghe — attenzione all’accento: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, indicator /ˈɪn.dɪˌkeɪ.tə(ɹ)/, indication /ɪndɪˈkeɪʃən/, anatomy /əˈnætəmi/, auxiliary /ɔɡˈzɪl.(jə).ɹi/
I suoni difficili per chi parla italiano:
- /h/ — va soffiata, non è muta: helpful /ˈhɛlp.fl̩/, whereas /(h)wɛɹˈæz/, highlight /ˈhaɪˌlaɪt/
- Consonante finale — senza aggiungere una vocale dopo: fluid /ˈflu.ɪd/, probe /pɹoʊb/, indicate /ˈɪndɪˌkeɪt/, assessment /əˈsɛsmənt/, assess /əˈsɛs/
- /æ/ — più aperta della “e”: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, arrow /ˈæɹəʊ/, scan /skæn/, bladder /ˈblædɚ/, anatomy /əˈnætəmi/
Come esercitarsi con questo video
- Ascolta tutto il video una volta senza parlare e annota le parole che non conosci.
- Inizia a velocità 0,75×, fai shadowing frase per frase e torna alla velocità normale quando diventa facile.
- Registrati e confronta con l’originale, facendo attenzione a parole come fluid, probe, examination.
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.