In the Emergency Department, it is important to get answers quickly in patients presenting with acute traumatic injury, shock, bleeding, or respiratory distress. In these life-threatening scenarios, ultrasound can provide answers quickly with one transducer in less than five minutes. The eFAST exam (Extended Focused Assessment with Sonography in Trauma) is performed to evaluate the heart, pelvis, abdomen, and lung with one scan and can guide treatment for the unstable patient. The goal of this protocol is to quickly assess the patient for free fluid. The eFAST exam includes five-to-six views; (1) Right Upper Quadrant (RUQ), (2) Cardiac (subcostal) view, (3) Left Upper Quadrant (LUQ), (4) Pelvic view, (5) Right Lung, and (6) Left Lung. The diagram below represents the locations of these 6 views. In the abdominal views, including RUQ and LUQ, free fluid can be easily seen with ultrasound.

Efast diagrom

RUQ (Right Upper Quadrant) – eFAST

RUQ (Right Upper Quadrant) – eFAST
RUQ (Right Upper Quadrant)
Fluid in Morrison's pouch – eFAST
Fluid in Morrison's pouch

Cardiac view – eFAST

Cardiac view – eFAST
Cardiac view

Left Upper Quadrant (LUQ) – eFAST

Left Upper Quadrant (LUQ) – eFAST
Left Upper Quadrant (LUQ)

Normal bladder (pelvic) – eFAST

Normal bladder (pelvic)
Normal bladder (pelvic)
Free fluid in the pelvis – eFAST
Free fluid in the pelvis

Lung view – eFAST (Legend)

Lung view – eFAST
Lung
  1. Waves
  2. Sandy beach