Clinical Indication

Blunt and penetrating trauma, hypotension/shock, ruptured ectopic pregnancy, paracentesis

Probe Selection

Sector or Curvilinear

Tips

  • Start with the subxyphoid view first, this will change immediate management (i.e. ED thoracotomy)
  • The RUQ view (coronal plane) should contain the R lung base (R4), Morison's pouch (the most dependent portion in a supine patient), and the liver tip
  • The LUQ view (coronal plane) should contain the L lung base (L4), the tip of the spleen, and the spleno-renal recess
  • The pelvic/suprapubic view (transverse and sagittal planes) should image the recto-vesicular pouch in males and the Pouch of Douglas in females
  • Extended FAST (E-FAST) includes lung views to evaluate for PTX, apical first in an upright patient, anterior in a supine patient
  • Consider an E-FAST as part of your overall RUSH exam (Rapid Ultrasound in Shock) in any patient with undifferentiated hypotension.  More on that here.