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POCUS Made Easy: eFAST

eFAST (Focused Assessment with Sonography in Trauma) is used to look for pathology in trauma such as haemothorax, pneumothorax, haemoperitoneum and haemopericardium and looking for free fluid in ectopic pregnancy


Pre-reading
eFAST right Chest view
1. Right Chest view
  • Labelled RIGHT
  • Longitudinal view
  • Demonstration of lung sliding with M-mode
eFAST left Chest view
2. Left Chest view
  • Labelled LEFT
  • Longitudinal view
  • Demonstration of lung sliding with M-mode
eFAST RUQ
3. RUQ view 
  • Labelled RUQ 
  • Longitudinal view
  • Demonstration of the inferior hepatorenal interface (Morrison’s Pouch) + inferior liver tip 
eFAST RUQ 2
4. RUQ view 2
  • Labelled RUQ 
  • Longitudinal view
  • Demonstration of R lung base 
eFAST LUQ
5. LUQ view 
  • Labelled LUQ 
  • Longitudinal view
  • Demonstration of the splenorenal interface
eFAST LUQ 2
6. LUQ view 2 
  • Labelled LUQ 
  • Longitudinal view
  • Demonstration of Left Lung Base 
eFAST Pelvis
7. Pelvis view 
  • Labelled PELVIS 
  • Longitudinal view
  • Females: Demonstration bladder, uterus, Pouch of Douglas & rectum.
  • Males: bladder, prostate & rectum 
eFAST subxiphoid
8. Subxiphoid view (or Parasternal Long Axis) 
  • Labelled SUBX (or PLAX)
  • Transverse  view
  • Demonstration of the pericardium 

Image Sets

  • Minimum 8 Still Images
  • 8-12 images
  • Optional extra views including Pelvis Trans

Machine Settings

  • CURVILINEAR Probe. But can change to optimise image 
  • ABDO setting for all images

Documentation – Pocus eFAST

  • Views: Adequate/ Inadequate
  • Findings: NAD / eFAST +ve (Free fluid/ Pneumothorax/Pericardial Effusion/ Pleural Effusion) 
Positive Findings (always consider clinical context)

References and Further reading

Bendigo ED Resource PDF – eFAST

Clinical Cases


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POCUS

made easy

MBChB FACEM CCPU. Emergency Physician at Bendigo Hospital and Royal Melbourne Hospital, Victoria. Australia.
I studied in Scotland before completing my Emergency Medicine training in Melbourne. I have a big interest in point-of-care ultrasound use and training in Emergency Medicine. I'm also interested in Choosing Wisely and sustainability initiatives in healthcare.
In my free time you'll find me playing tennis and soccer, or heading outdoors on camping trips.

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