FAST exam
Formal Definition
Focused Assessment with Sonography in Trauma: a point-of-care ultrasound protocol that assesses four windows for free fluid (blood) — pericardium, right upper quadrant, left upper quadrant, and pelvis.
How It's Used on the Ward
"Run a FAST" or "FAST is positive" — performed at bedside within minutes of trauma arrival to identify hemorrhage without moving the patient.
Example
""Stabbing victim: FAST positive in RUQ and pelvis — massive hemoperitoneum. Surgeons called immediately, patient to OR within 8 minutes of arrival.""
Clinical Context
FAST identifies free fluid (blood), not the specific organ injured. A positive FAST in a hemodynamically unstable patient = OR now, no CT. A negative FAST doesn't exclude injury — small bleeds and retroperitoneal injuries are missed. Extended FAST (eFAST) adds lung windows to assess for pneumothorax and hemothorax.
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