The Cardiovascular
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Focused Assessment with Sonography for Trauma (FAST)

Bedside ultrasound for free fluid in trauma.

Focused Assessment with Sonography for Trauma (FAST)
Pericardial (subxiphoid) view
Right upper quadrant (perihepatic / Morison pouch)
Left upper quadrant (perisplenic)
Suprapubic / pelvic view
Thoracic views (eFAST - pneumo/haemothorax)
ResultNegative FAST

No free fluid detected. A negative FAST does not exclude injury; repeat or use CT if clinical suspicion persists.

Positive views
0

When to use

  • Rapid bedside evaluation for free intraperitoneal or pericardial fluid (and, with eFAST, pneumo/haemothorax) in trauma.

Formula

A FAST is positive if free fluid is identified in any interrogated window (pericardial, perihepatic, perisplenic, pelvic, or thoracic for eFAST).

Pearls and pitfalls

  • Most useful to rule IN free fluid in the unstable patient; sensitivity is limited and a negative exam does not exclude injury.
  • Serial examinations increase sensitivity as fluid accumulates.

References

  1. Rozycki GS, et al. Ann Surg. 1998;228(4):557-67.