Orthopaedics & Trauma Emergency Medicine Surgery Strong — ATLS 10th Ed; standard of care in trauma

FAST Exam Protocol — Focused Assessment with Sonography in Trauma

Structured 4-window ultrasound assessment to detect free fluid (haemoperitoneum, haemopericardium) in trauma. Extended FAST (eFAST) adds bilateral pleural windows.

Result

FAST is a bedside ultrasound examination, not a points score. It looks for free fluid in the pericardium, the hepatorenal pouch (Morison's), the splenorenal recess and the pelvis; eFAST adds both pleural spaces (absent lung sliding suggests a pneumothorax). Free fluid in a haemodynamically unstable patient points to the bleeding source and the need for immediate surgical control; a stable patient with free fluid is usually assessed with CT. A negative FAST does not exclude injury — it misses retroperitoneal bleeding and small volumes — so repeat it, reassess and look for other sources of bleeding (ATLS).

References

ATLS Student Course Manual, 10th Edition. American College of Surgeons. 2018.
Rozycki GS et al. The role of surgeon-performed ultrasound in patients with possible cardiac wounds. Ann Surg. 1996.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

References

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