FAST

= Focused Assessment with Sonography in Trauma

: Andreas
By
 Introduction
• Is rapid, bedside, non invasive , ultrasound examination performed to
identify intra-peritoneal haemorrhage or pericardial tamponade
• Emergency department by radiologist
• Portable ultrasound machine
• Curvilinear probe, 2.5 or 3.5MHz
• 2-10 minutes
• Look for free fluid in:
1. Perihepatic area
2. Perisplenic area
3. Pelvic area
4. Pericardial area
 Clinical Scenarios
• Hemodinamically unstable

• Need an emergent bedside procedure

• Require transfer to a trauma center

• Intoxicated patients

• Penetrating trauma with multiple wounds

• Injured patients but no indication for CT

 Location of probe placement for the
trauma examination

• 4 view
• capable to detect about 100-250ml free fluid
Emergency ultrasound, UK
1. Perihepatic Area (Coronal View)

Probe: mid-axillary line at about the

8th to 11th intercostal space with the
marker-dot pointed cephalad

Emergency ultrasound, UK
1. Perihepatic Area (Intercostal oblique View)

Probe: rotate the probe counter-

clockwise, so the marker-dot pointed to
posterior axilla
2. Perisplenic Area (Coronal View)

Probe: posterior axillary line at

about the 6th to 9th intercostal space
with the marker-dot pointed cephalad

Emergency ultrasound, UK
2. Perisplenic Area (Intercostal oblique View)

Probe: rotate the probe clockwise, so

the marker-dot pointed to posterior
axilla

Normal perisplenic view

3. Pelvic Area (Longitudinal View)

Probe: midline just cephalad to the

pubic bone with the marker-dot
pointed cephalad
3. Pelvic Area (Transverse View)

Probe: rotate 90 degrees with the

marker-dot pointed to the patient’s
right side
4. Pericardial Area (Subxiphoid Four-Chamber
View)
Probe: subxiphoid region with the
marker-dot pointed to the patient’s
right side or right shoulder

Emergency ultrasound, UK
4. Pericardial Area (Parasternal Long-Axis
View)
Probe: just to the left of the
sternum at about 4th or 5th intercostal
space with the marker-dot toward the
4 o’clock position
THANK YOU
SUGGESTION PLEASE