POCUS View

Extended FAST (EFAST)

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Video coming September 2026

How to Perform

Perform the four standard FAST views (subxiphoid pericardial, right upper quadrant hepatorenal, left upper quadrant splenorenal, and suprapubic pelvic) with a curvilinear or phased-array probe, then extend the examination to the thorax: place a probe at the anterior chest in the midclavicular line over several intercostal spaces on each side to assess for lung sliding, and image the bilateral costophrenic recesses above the diaphragm for pleural fluid.

How to Interpret

Blunt Thoracic Trauma with Pneumothorax or Hemothorax

Pleural sliding loss, pleural effusion, or other abnormal thoracic ultrasound findings on eFAST

Rule in

Very helpful

Rule out

Very helpful

Evidence:Strong

References

Stengel D, Leisterer J, Ferrada P, Ekkernkamp A, Mutze S, Hoenning A. Point-of-care ultrasonography for diagnosing thoracoabdominal injuries in patients with blunt trauma. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD012669. DOI: 10.1002/14651858.CD012669.pub2. PMID 30548249.
Kirkpatrick AW, Sirois M, Laupland KB, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma. 2004;57(2):288-295.