CPSS; THE FAST EXAM (FOCUSED ASSESSMENT
WITH SONOGRAPHY FOR TRAUMA TEST
QUESTIONS AND ANSWERS
1. Is there free fluid in the patient's pericardium, pelvis, abdomen, or thorax as a
result of blunt force trauma?
Which clinical question signals that a FAST test is necessary?
An indication of free fluid in the pericardium is pericardial effusion.
Anechoic collection that is free between the heart and the pericardium
An indication of free fluid in the thoracic cavity is pleural effusion.
In the pleural spaces directly above the diaphragm, there is free anechoic
collecting.
Free fluid indicators in the RUQ abdomen
In the RUQ, free anechoic collection:
Morrison's Pouch, also known as the hepatorenal recess, is the right kidney's
inferior pole.
The subphrenic recess
Free fluid indicators in the LUQ abdomen
In the LUQ, free anechoic collection:
The inferior pole of the left kidney and the splenorenal recess
indications of pelvic fluid leakage
Pelvic free anechoic collection:
In females, rectouterine recess and/or vesicouterine recess
, The male retrovesical pouch
1. RUQ and right thoracic space (upper and lower poles of the kidney, kidney-
liver interface)
2. The right thoracic space and RUQ (move just cephalad enough to bring the
diaphragm to the center of the image to show the diaphragm, interface with the
liver, upper pole of the kidney, and thoracic space where a hemothorax would
accumulate)
The left thoracic space and LUQ, including the upper and lower poles, the
interaction with the spleen, and a portion of the diaphragm.
4. LUQ and left thoracic space: Bring the diaphragm to the center of the image
by moving the probe slightly cephalad. The diaphragm, spleen, kidney, and
thoracic cavity above it are still present.
5. Subxiphoid cardiac view: searching for effusions around the heart.
Pelvic views 6 and 7. Only two views were used for the FAST position. The
short axis views are 1 2 3 4. examining the bladder and the area where the
bladder, uterus, and prostate meet. Small pouches must be visible in both long
and transverse axis views.
What are the seven FAST exam probe positions?
Site 1: RUQ: fluid may pool in Morrison's pouch, which is the kidney-liver
interface.
What do you see in this picture?
Location 2: RUQ
To inspect the lower thoracic cavity, where fluid may collect, slide superiorly
along the mid-axillary line. See the mirror artifact normally. It would be
anechoic and the artifact would vanish if there was a buildup of blood or fluid.
WITH SONOGRAPHY FOR TRAUMA TEST
QUESTIONS AND ANSWERS
1. Is there free fluid in the patient's pericardium, pelvis, abdomen, or thorax as a
result of blunt force trauma?
Which clinical question signals that a FAST test is necessary?
An indication of free fluid in the pericardium is pericardial effusion.
Anechoic collection that is free between the heart and the pericardium
An indication of free fluid in the thoracic cavity is pleural effusion.
In the pleural spaces directly above the diaphragm, there is free anechoic
collecting.
Free fluid indicators in the RUQ abdomen
In the RUQ, free anechoic collection:
Morrison's Pouch, also known as the hepatorenal recess, is the right kidney's
inferior pole.
The subphrenic recess
Free fluid indicators in the LUQ abdomen
In the LUQ, free anechoic collection:
The inferior pole of the left kidney and the splenorenal recess
indications of pelvic fluid leakage
Pelvic free anechoic collection:
In females, rectouterine recess and/or vesicouterine recess
, The male retrovesical pouch
1. RUQ and right thoracic space (upper and lower poles of the kidney, kidney-
liver interface)
2. The right thoracic space and RUQ (move just cephalad enough to bring the
diaphragm to the center of the image to show the diaphragm, interface with the
liver, upper pole of the kidney, and thoracic space where a hemothorax would
accumulate)
The left thoracic space and LUQ, including the upper and lower poles, the
interaction with the spleen, and a portion of the diaphragm.
4. LUQ and left thoracic space: Bring the diaphragm to the center of the image
by moving the probe slightly cephalad. The diaphragm, spleen, kidney, and
thoracic cavity above it are still present.
5. Subxiphoid cardiac view: searching for effusions around the heart.
Pelvic views 6 and 7. Only two views were used for the FAST position. The
short axis views are 1 2 3 4. examining the bladder and the area where the
bladder, uterus, and prostate meet. Small pouches must be visible in both long
and transverse axis views.
What are the seven FAST exam probe positions?
Site 1: RUQ: fluid may pool in Morrison's pouch, which is the kidney-liver
interface.
What do you see in this picture?
Location 2: RUQ
To inspect the lower thoracic cavity, where fluid may collect, slide superiorly
along the mid-axillary line. See the mirror artifact normally. It would be
anechoic and the artifact would vanish if there was a buildup of blood or fluid.
