Bedside ultrasound (Part 2) - The FAST examination

Abstract

In the setting of blunt or penetrating injury to the abdomen and chest, bedside ultrasound in the form of the extended-focused assessment with sonography for trauma (E-FAST) examination plays a vital role in rapid diagnosis of bleeding in the abdominal and thoracic cavities. Rapid diagnosis and intervention based on the diagnosis is associated with better treatment outcomes. E-FAST is rapid, can be done along with the primary and secondary survey without disrupting resuscitative measures, is noninterventional, and does not involve exposure to ionizing radiation. It can be used to detect hematoma in the intraperitoneal cavity and pelvis, hemothorax, pneumothorax, and pericardial effusion using eight standard views. The disadvantages are that it is operator dependent and requires some amount of training, and a negative E-FAST study does not necessarily exclude serious intra-abdominal injury.