Focused Assessment with Sonography in Trauma

What Is Focused Assessment with Sonography in Trauma?

Focused Assessment with Sonography in Trauma (FAST) is a rapid bedside ultrasound protocol used in emergency departments and advanced EMS systems to scan four anatomical windows — pericardial, right upper quadrant (Morison's pouch), left upper quadrant (splenorenal), and pelvis — for free fluid (hemorrhage) or pericardial tamponade.

Why Focused Assessment with Sonography in Trauma Matters on the Fireground

Blunt abdominal trauma can cause severe internal bleeding without early external signs. A positive FAST scan rapidly identifies intraperitoneal bleeding or cardiac tamponade, expediting immediate transfer to the operating room.

Relevant NFPA Standards

• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards
• NFPA 455: Standard for Emergency Medical Services (EMS)

Field Procedures & Tactical Steps

1. Position the ultrasound machine and apply acoustic gel to the low-frequency phased array probe.
2. Obtain the Cardiac View (subxiphoid or parasternal) to assess for pericardial effusion or tamponade.
3. Scan the Right Upper Quadrant (Morison's pouch between liver and kidney) for free fluid collection.
4. Scan the Left Upper Quadrant (splenorenal space) and Pelvis (suprapubic view of pouch of Douglas / retrovesical space).
5. Document findings and report positive fluid signatures directly to the trauma surgeon or receiving physician.

Common Context & Application

Performed during trauma resuscitation in emergency departments and by critical care paramedic ground/flight crews during transport.

Frequently Asked Questions about Focused Assessment with Sonography in Trauma