FAST

The FAST exam, per ATLS protocoll, is performed immediately after the primary survey of the ATLS protocol.  Ultrasound is the ideal initial imaging modality because it can be performed simultaneously with other resuscitative cares, providing vital information without the time delay caused by radiographs or computed tomography (CT).  The concept behind the FAST exam is that many life-threatening injuries cause bleeding.  Although ultrasound is not 100% sensitive for identifying all bleeding, it is nearly perfect for recognizing intraperitoneal bleeding in hypotensive patients who need an emergent laparotomy and for diagnosing cardiac injuries from penetrating trauma.(6-9)  Recently, research studies have shown that bedside ultrasound is equivalent to, or better than, chest radiography for identifying a hemothorax or pneumothorax in trauma patients.