The FAST exam (Focused Assessment with Sonography for Trauma) is a rapid, standardized point-of-care ultrasound protocol used in trauma resuscitation to detect free intraperitoneal and pericardial fluid. The Extended FAST (eFAST) adds bilateral lung views to identify pneumothorax and hemothorax.
The standard FAST protocol includes four views: the right upper quadrant (Morrison’s pouch), left upper quadrant (splenorenal space), subxiphoid cardiac window, and suprapubic pelvis. Each view is scanned in seconds to identify anechoic fluid — blood — that indicates solid organ injury or cardiac tamponade requiring immediate intervention. The eFAST adds anterior lung sliding assessment and bilateral pleural views.
FAST competency is incorporated into trauma sonography training and is also taught in emergency medicine and surgery residencies. Sonographers supporting trauma teams hold RDMS credentials and often work alongside physicians who independently perform FAST assessments. Trauma centers, emergency departments, and military medical units are the primary settings for this examination.