Starting the FAST
FAST - Focused Assessment With Sonography In Trauma
- The first integrated POCUS
- Used to be “focused abdominal sonography in trauma”
- >>> Now Focused Assessment with Sonography in trauma
- Includes peritoneal, pelvic, thoracic, and pericardial spaces
- Looking for fluid, presumed to be blood, in these sites
Narration
EFAST – Extended Focused Assessment With Sonography In Trauma
- EFAST or extended FAST adds thoracic spaces for pneumothorax
Narration
EFAST – Extended Focused Assessment With Sonography In Trauma
- The best initial imaging modality in trauma
- Performed as part of primary or secondary survey in trauma
- No ionizing radiation
- Repeatable
- Sensitive for significant fluid (typically, near 100% sensitive for 500cc or more)
- Not meant to replace CT
Narration
EFAST – Probe Selection
Narration
Blunt Trauma – Morison’s Pouch
- Right flank, coronal plane, indicator to head
- Interrogate entire area including liver tip
- Most sensitive place for fluid
- Even with splenic rupture
- Is position dependent – may take time laying flat to accumulate here
- May detect as little as 200cc fluid
- Sensitivity very high for 500cc+
