eFAST — Extended FAST

1. 1

   Position patient supine. Select phased array or curvilinear probe.

2. 2

   Start at RUQ (Morison's pouch): place probe in right mid-axillary line, 8th–11th ICS, marker toward head. Look for anechoic fluid between liver and kidney.

3. 3

   Move to LUQ (splenorenal): probe in left posterior axillary line, 8th–11th ICS. Look for fluid between spleen and left kidney and above the spleen.

4. 4

   Pelvis: probe suprapubic, marker toward head (sagittal), then rotate 90° (transverse). Look for fluid posterior to bladder/uterus.

5. 5

   Subxiphoid cardiac: flat probe angle under xiphoid, marker to patient's right. Look for pericardial effusion and gross cardiac function.

6. 6

   Bilateral lung bases: probe at 2nd–3rd ICS, mid-clavicular line, marker toward head. Confirm lung sliding (rules out pneumothorax).

7. 7

   Document each view. A positive eFAST (free fluid or absent sliding) warrants immediate surgical or clinical escalation.

• RUQ (Morison's Pouch)
• LUQ (Splenorenal)
• Pelvis (Retrovesical/Retrouterine)
• Subxiphoid Cardiac
• Bilateral Lung (×2)

• Free fluid (anechoic stripe)
• Pericardial effusion
• Lung sliding (PTX)
• Hemopneumothorax

• Perinephric fat vs. fluid
• Collapsed IVC vs. fluid
• Suboptimal subxiphoid window

Always start with RUQ — highest yield in trauma. Compare both flanks symmetrically.