Core Studies
EFAST
Extended-Focused Assessment with Sonography in Trauma
The FAST scan (and more recently, E-FAST) is a particular protocol for conducting a focused screening trauma patients for evidence of solid organ injury. In the context of trauma, Free fluid in the abdomen is assumed to be blood. Therefore, the E-FAST answers four yes/no questions:
Purpose
- Is there haemoperitoneum?
- Is there haemothorax?
- Is there haemopericardium?
- Is there pneumothorax?
It is supposed to be quick (< 2 minutes), and conducted at the completion of your primary assessment.
The sensitivity of FAST for detecting intraperitoneal fluid has been reported to be between 200 to 800mls. A good number to remember is about 400ml must be present in the peritoneum to be detected on FAST exam.
A negative E-FAST does NOT exclude serious injury!
Regions of the scan
Clinical Indications
- Acute blunt or penitrating torso trauma
- Trauma in pregnancy
- Paediatric trauma
- Subacute torso trauma
- Undifferentiatied hypotension
What EFAST cannot tell you
- Source of free fluid
- Nature of free fluid; for example, blood versus ascites
- Presence of solid organ or hollow viscus injury
- Presence of retroperitoneal injury.
- Exactly what action needs to be taken next to optimise and treat the patient