E-FAST

The Extended Focussed Assessment with Sonography in Trauma (E-FAST) employs additional chest views to the regular FAST specifically to rule out pneumothorax and forms part of the primary survey assessment done in trauma.

A systematic review by Netherton et al.⁷ found seventy-five studies comprising 24,350 patients. Studies were found between 1989 and 2017. Pooled sensitivities and specificities were calculated for the detection of pneumothorax (69% and 99% respectively), pericardial effusion (91% and 94% respectively), and intra-abdominal free fluid (74% and 98% respectively).

Sub-group analysis was completed for detection of intra-abdominal free fluid in hypotensive (sensitivity 74% and specificity 95%), adult normotensive (sensitivity 76% and specificity 98%) and paediatric patients (sensitivity 71% and specificity 95%).

A Cochrane review in 2015 analysed four studies, which were found to be of low to moderate methodological quality with strong heterogeneity. The study failed to demonstrate a mortality benefit or reduction in CT scanning secondary to FAST scanning.⁸