Focused Assessment with Sonography in Trauma

1. Here’s a great example of free fluid in the Right Upper Quadrant (Morrison’s Pouch).

This patient was ejected from his vehicle at highway speeds. He managed to get up and walk several kilometers to get help. This scan was done approximately 10 hours after time of injury. If you look carefully, you can see that the free fluid (blood) in his abdomen is starting to organize into clot (white web-like structures within the free fluid), highlighting an important limitation to FAST: at 24 hours following injury, the sensitivity of FAST drops significantly as intrabdominal blood may become organized (clot) and thus become indistinguishable from normal organ structures within the abdomen.