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Extended FAST (eFAST) Trauma Ultrasound

Rapid screening for free abdominal fluid, pericardial effusion and pneumothorax in blunt and penetrating trauma.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Extended FAST (eFAST) Trauma Ultrasound?

Extended Focused Assessment with Sonography for Trauma (eFAST) is a point-of-care ultrasound protocol used in the emergency department for the trauma patient. The aim is to detect pericardial, periportal, perisplenic and pelvic free fluid and to screen for pneumothorax and haemothorax.

Classical FAST windows are subxiphoid (pericardium), right upper quadrant (Morison pouch), left upper quadrant (splenorenal) and suprapubic (pouch of Douglas). Extended FAST adds bilateral anterior lung apices (sliding sign) and posterolateral sinuses (haemothorax).

eFAST is sensitive for intra-abdominal haemorrhage in the haemodynamically unstable trauma patient and is more sensitive than CT for pneumothorax. A negative eFAST does not exclude pelvic fracture or retroperitoneal bleeding.

Symptoms

Blunt or penetrating trauma history
Unexplained hypotension
Abdominal tenderness and distension
Chest pain and dyspnoea
Pericardial tamponade with Beck triad
Tension pneumothorax features
Suspected pelvic fracture
Multi-mechanism trauma

Risk Factors

High-energy traffic accident
High fall
Penetrating thoracic or abdominal injury
Pregnancy with trauma
Obesity (lower image quality)
Subcutaneous emphysema
Prior abdominal surgery
Assessment of unconscious patient

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Apply rapidly during major trauma triage
  • Helps the laparotomy decision in haemodynamic instability
  • Chest pain plus trauma plus hypotension
  • Unexplained hypotension on physical examination
  • Suspected pelvic fracture and blood loss
  • Dynamic monitoring during resuscitation

Treatment Methods

01
Curvilinear 3.5-5 MHz probe for the abdomen
02
Linear high-frequency probe for the lung
03
Supine and log-roll positioning
04
Four classical windows plus two pleural windows
05
Sliding sign rules out pneumothorax
06
M-mode showing seashore versus barcode sign
07
Rapid surgical consultation when positive
08
Serial assessment in the unstable patient
09
Trained operator required

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.