Usefulness of Extended-FAST (EFAST-Extended Focused Assessment with Sonography for Trauma) in critical care setting

Trauma is the leading cause of death in people below 45 years-old in Brazil, and responsible for one third of all intensive care unit admissions. The increasing knowledge on ultrasound diagnosis methods and its availability for life-threatening injuries (such as cardiac tamponade and abdominal cavity solid organs rupture leading to hemorrhagic shock) diagnosis and monitoring, lead to the development o the FAST (Focused Assessment with Sonography for Trauma) protocol, aimed to be used both in the emergency and intensive care unit settings. Due to its reproducibility, lack of radiation exposure, and bedside feasibility, this technology is being increasingly accepted. A new protocol extension, the Extended-FAST, provides valuable information for improved patients' management, extending its availability from the abdominal conditions to other diagnosis such as hemothorax, pleural effusion and pneumothorax. We must underline that this technique is able to replace computed tomography and diagnostic peritoneal wash, and do not delay surgical procedure instead of perform this exam . Thus, its careful appraisal in connection with the clinical information should guide the therapeutic approaches, specially in inhospitable sites such as intensive care units in war zones, rural or distant places, were other imagery methods are not available.