eFAST Trauma Ultrasound

What it does

eFAST Trauma Ultrasound reads the extended focused assessment with sonography for trauma performed in the primary survey: the right upper quadrant (hepatorenal space and right thorax), the left upper quadrant (splenorenal space and left thorax), the pelvis, the subxiphoid pericardial window and both anterior chest walls. Upload the four to six window clips, often exported as MP4 from a handheld device.

Each window comes back positive, negative or indeterminate, with the reason. Free fluid is located and sized, pericardial fluid is checked for tamponade signs, and the anterior chest clips are read for lung sliding and lung point. An overall eFAST result and next-step guidance sum up the scan.

Intended use

Decision support for the emergency or trauma physician who has just scanned an injured patient, and a structured record of the scan for the trauma chart and for teaching. Novices miss small volumes, and fluid-filled bowel or perinephric fat can mimic blood, so each positive window shows its evidence frame.

Who it is for

Emergency physicians, trauma surgeons, emergency medicine residents, prehospital and military clinicians who record eFAST clips, and ultrasound educators reviewing trainee scans. Developers add the run to handheld-ultrasound apps and trauma registries.

Accepted input

• Window clips: B-mode cine of each window as DICOM Ultrasound Multi-frame objects or MP4/MOV exports.
• Pelvic views: longitudinal and transverse clips are both accepted and read together.
• Chest clips: anterior chest wall on each side, B-mode with optional M-mode through the pleural line.

Requirements

Requirement	Why
Cine clips	Lung sliding exists only over time, and a sweep through each window shows fluid that one frame can miss
Landmarks in view (liver tip, kidney pole, diaphragm, bladder, heart)	A window is adequate only when its required landmarks are seen; otherwise it is indeterminate
One clip per anterior hemithorax	Pneumothorax is reported for each side

Obesity and subcutaneous emphysema degrade windows; the result names the window that failed and why. Size classes for fluid use the depth scale when one is readable.

Optional context

The clinical question, for example blunt trauma in a hypotensive patient, goes in clinical_context and frames the next-step guidance.

The result

One JSON result in sections with a per-window verdict table, findings, quality and fluid masks on the evidence frames, followed by the overall eFAST result. Indeterminate windows are listed with their reason.

Section	Content
Windows and adequacy	Window per clip (RUQ, LUQ, pelvis longitudinal and transverse, subxiphoid, left and right chest) and whether its required landmarks are seen
Free fluid	Anechoic free fluid by location (hepatorenal, perisplenic, pelvic, pleural or haemothorax) with a size class
Pericardial effusion	Pericardial fluid on the subxiphoid or parasternal view, with tamponade flags
Pneumothorax	Lung sliding and lung point on each anterior chest wall, with a pneumothorax probability
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• Protocol: ACEP emergency ultrasound guidelines for the eFAST windows and their interpretation as positive, negative or indeterminate.
• DICOM: SR Measurement Report TID 1500; SEG for fluid masks; key frames and MP4 overlays showing the evidence.

Reading notes

Fluid in Morison's pouch, the splenorenal recess or the pelvis is reported with its location, because the location points to the injured organ. The pneumothorax read is the same one used in lung ultrasound, applied to the trauma windows.

Related models

• us/lung reads a full lung ultrasound protocol.
• us/echo (focused section) and us/abdomen (aorta) extend an undifferentiated-shock work-up.