Penetrating abdominal trauma: begin with a cardiac view.Blunt abdominal trauma: begin with a right upper quadrant view.The sequence in which each view is obtained can vary based on the mechanism of injury. You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation. If possible, adjusting the bed to place the patient in the Trendelenburg position and/or with their arms behind their head can improve the sensitivity of the examination. Don probe cover if present and apply gel to the ultrasound probe. Place the ultrasound machine across the patient within your eye line (if possible).ĥ. Position yourself on the right side of the patient (if possible).Ĥ. Adequately expose the patient for the examination.ģ. Position the patient supine if not so already.Ģ. Gain consent to proceed with the examination.ġ. The procedure may feel a little uncomfortable but shouldn’t be painful.” This will help us to plan your future management to the best of our ability. Where possible, briefly explain what the procedure will involve using patient-friendly language: “Today I need to perform a FAST exam of your abdomen, which involves using an ultrasound to view your internal organs. Introduce yourself to the patient including your name and role.Ĭonfirm the patient’s name and date of birth. If your hands are visibly soiled, wash them with soap and water.
Ultrasound probes, from left to right: (a) phased array (b) curvilinear (c) linear. This removes any need to switch probes mid-exam. The curvilinear probe is the probe of choice for the eFAST exam as it allows for both adequate penetration and image resolution in all areas examined. Air does not allow ultrasound to penetrate deeper tissue.Ĭollect all equipment needed for the exam and place it within reach at the patient’s bedside. The FAST exam is less sensitive in the setting of penetrating trauma than blunt trauma due to air in the peritoneal or pleural spaces.
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A scan is deemed positive if any free fluid is visualised. The extended FAST includes the additional evaluation of the anterior and lateral pleural spaces to evaluate for pneumothorax or pleural fluid, presumed to be a haemothorax until proven otherwise in the setting of trauma. The basic FAST exam assesses four standardised ultrasound views along the chest and abdomen, making use of gravity-dependent regions to rapidly identify intraperitoneal and/or pericardial fluid. The Extended Focused Assessment using Sonography in Trauma (eFAST) is a sonographic examination that can be incorporated in the evaluation of patients with blunt or penetrating trauma to the torso.
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