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Updated: Aug 24, 2026
Focused Assessment with Sonography for Trauma (FAST) Exam: Image Acquisition
Published on: September 22, 2023
The hand-held ultrasound examination for penetrating abdominal trauma
Andrew W Kirkpatrick1, Marco Sirois, Chad G Ball
1Department of Critical Care Medicine, Foothills Medical Center, Calgary, Alberta, Canada. andrew.kirkpatrick@calgaryhealthregion.ca
Background:
An evaluation of hand-held ultrasonography (US) in the assessment of penetrating torso trauma has not yet been reported.
Methods:
A 2.4 kg hand-held ultrasound device was used to examine penetrating trauma victims in an exam designated as the Hand-Held Focused Assessment with Sonography for Trauma (HHFAST). Results were compared with other US examinations including formal FAST (FFAST), computed tomography, diagnostic peritoneal lavage, operative and autopsy findings, and serial examination. Performance considered both the detection of fluid and injuries requiring intervention.
Results:
The HHFAST was excellent for detecting free intraperitoneal fluid, which had 100% specificity for peritoneal penetration, but was only moderately sensitive for injuries requiring therapy.
Conclusions:
Hand-held sonography can quickly detect intraperitoneal fluid, which has good test performance in determining the presence of an intra-abdominal injury. Negative FAST examinations after penetrating trauma should be followed up with another diagnostic modality.
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