Summary of the FASH exam as explained in the
-RUQ: Ascities, pleural effusion
-LUQ: Ascities, pleural effusion
-Bladder: Ascities behind bladder
-SubX: Pericardial Effusion
TB Pericardial effusion needs to be drained completely so they don’t develop fibrinous pericarditis. Drain with indwelling catheter
-Spleen Sweep view
Microabscesses liquiefied in spleen–also use high frequency probe
-Liver Sweep view
Lowest yield, most difficult exam, lowest OR.
Stage lesions, initially hyper echoic progressing to micro then macro abscesses
Start at aorta in transverse, scan down to bifurcation
look for “hot grapes” Lymph nodes are NOT subtle.
This exam is studied in the setting of very high prevalence of TB in the developed world, decreased prevalence will decrease PPV and increase NPV. Making this a potential screening tool to determine isolation need in patients where this is suspected.