
FAST and eFAST Protocol Guide
Overview
The Focused Assessment with Sonography for Trauma (FAST) exam is a rapid bedside protocol used to detect free fluid in the peritoneal and pericardial spaces. The extended eFAST adds bilateral pleural assessment for pneumothorax detection. This guide covers all four FAST windows and the two pleural views with practical scanning tips.
Key Clinical Points
Four standard FAST windows: perihepatic, perisplenic, pelvic (Morrison and splenorenal), and subcostal cardiac
Extended eFAST adds bilateral anterior chest views for pneumothorax
Free fluid appears anechoic (black) in the dependent spaces
Sensitivity improves with the patient in supine position
A positive FAST in an unstable patient warrants immediate surgical consultation
Use the convex probe (low frequency) for abdominal windows and the linear or phased array for cardiac and pleural
Related Specialties
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