eFAST fundamentals

This section is a selection of key principles of the eFAST exam to enhance comprehension and skill development in eFAST. We will outline the necessary knowledge, skills and attitudes to perform the eFAST examination.

LEarning the efast exam

Learning the eFAST exam can be divided roughly into three separate stages of learning. Often the the importance of acquisition and the role of image optimization are under-emphasized. We have attempted to address this. We have broken down the eFAST exam into a series of tutorials to help you understand each component. Our hope is to maximize the hands-on training time during the workshop by providing focused tutorials in advance.

Anatomical planes

It is helpful to understand the basic anatomic planes as they pertain to sonographic imaging. Because ultrasound is 2-dimensional, having versatility in different imaging planes is a helpful skill to interrogate potential pathology.

Oreintation and setup

Traditional imaging places the screen marker left and probe marker towards head (longitudinal plane) or screen marker left and probe marker patient right (axial/transverse plane). Cardiology-based imaging places the screen marker right with various probe marker configurations, but is largely opposite to traditional imaging standard.

Probe selection

Each probe has a potential role in the eFAST exam. In general, the phased array is the most versatile for cardiac, thoracic and abdominal imaging. However, the curvilinear with it’s low frequency and broad footprint, is also ideal for abdominal imaging. The linear probe is an ideal adjunct for vascular imaging and examination of lung artifacts.

Probe movements

It is crucial to understand probe movements and manipulation. This technical review by Bahner et al. (2016) is a helpful document to understand these principles.

Image interpretation

Every image obtained should be evaluated for key aspects:

Limitations & considerations

Here are select concerns of the eFAST exam you must be familiar with. This list is not all inclusive but covers the major pitfalls.

References

Bahner DP, Blickendorf JM, Bockbrader M, et al. Language of Transducer Manipulation. J Ultrasound Med. 2016;35(1):183-188. doi:10.7863/ultra.15.02036.