Summary

The eFAST examination has become a cornerstone of the evaluation of the critically ill trauma patient. The clinical context of the injury and hemodynamic status must be incorporated into the order and interpretation of the exam components. Utilize the “three box” concept as a framework and modify the order of the eFAST components depending on the mechanism of trauma and the patient’s clinical status. Proper and granular communication of ultrasound findings should be relayed to your trauma colleagues and interpreted in the hemodynamic clinical context of the patient. Finally, when faced with the newly or persistently hypotensive patient after an initially negative eFAST exam, a structured algorithm should be employed to reduce cognitive load in an often stressful situation. Our simple additions to the eFAST examination in no way replace the amazing work done by numerous physicians who have brought this life-saving tool into trauma care, but rather a minor refinement to an integral exam in modern trauma resuscitation.

Dr. Leu is an ultrasound fellow at Highland Hospital.

Dr. Mantuani is the ultrasound fellowship director at Highland Hospital.

Dr. Sobrero is an ultrasound fellow at Highland Hospital.

Dr. Nagdev is director of emergency ultrasound at Highland Hospital.

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