AFAST

AFAST Abdominal Focused Assessment in Trauma/Triage

Developed as a technique for quick assessment in emergent patients. Only novice ultrasound skills are necessary to begin utilizing this tool.

Procedure

Right lateral recumbency

Place probe in 4 areas and assess if free abdominal fluid is present or not. For each position, give a score of 1 or 0. Additional findings besides fluids will be described below.

DH view - Diaphragmatic/Hepatic View

SR view - Spleno-Renal view

CC view - Cysto-colic view

HR view - Hepato-Renal view

DH view (Diaphragmatic/Hepatic view)

Probe is placed with ultrasound marker ventral on left side of screen.

Organs to be identified:

Caudal lung margin - can evaluate for pulmonary edema, nodules, pneumonia, PTE

Diaphragm - evaluate for hernia

Liver - evaluate for general liver size, echogenicity, obvious masses

Gall bladder - evaluate for mucoceole, wall edema consistent with anaphylaxis

Peritoneal cavity - evaluate for free fluid

Caudal vena cava - evaluate size as it crosses the diaphragm. Collapsed - hypovolemia. Distended - R sided CHF vs volume overload. Expand and contract by 50% diameter is normal

Hepatic veins - distended consistent with volume overload or R sided CHF

Thoracic cavity - evaluate for pleural effusion

Pericardial sac - evaluate for pericardial effusion

Heart apex +/- chambers - general idea of size and filling