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Focused Assessment with Sonography for Trauma (FAST) Exam: Image Acquisition
Published on: September 22, 2023
Retrospective Analysis of eFAST Exams to Detect COVID-19 in Trauma Patients
Nicholas Gossett1, Michelle Thao Nguyen1, Roy Almog2
1School of Medicine, University of California Irvine, Orange, California, USA, uci.edu.
Emergency Medicine International
|August 5, 2026
Summary
Pulmonary point-of-care ultrasound (POCUS) in trauma patients is not reliable for detecting asymptomatic COVID-19. Standard PCR testing and PPE remain crucial for healthcare provider protection.
Area of Science:
- Emergency Medicine
- Radiology
- Infectious Disease
Background:
- Evaluating pulmonary point-of-care ultrasound (POCUS) utility within the extended focused assessment with sonography in trauma (eFAST) exam.
- Assessing lung findings (B-lines, pleural thickening, subpleural consolidations) for asymptomatic COVID-19 detection in emergency department trauma patients.
Purpose of the Study:
- Determine if lung POCUS integrated into eFAST can identify asymptomatic COVID-19 in trauma patients.
- Analyze the diagnostic accuracy of specific ultrasound lung findings for COVID-19.
Main Methods:
- Retrospective review of trauma patients (≥18 years) who underwent eFAST and COVID-19 swab testing.
- Two blinded reviewers analyzed eFAST scans for specific lung abnormalities; discrepancies resolved by ultrasound fellows.
- Calculated sensitivity, specificity, and predictive values with 95% confidence intervals.
Main Results:
- 152 patients included; 41 eFAST scans showed COVID-19 findings, with only 6 confirmed by PCR (15.6% positive predictive value).
- 111 eFAST scans negative for COVID-19 findings included 10 PCR-positive cases (91.0% negative predictive value).
- Sensitivity was 37.5% and specificity was 74.3% for detecting COVID-19.
Conclusions:
- Lung POCUS within the eFAST exam is unreliable for detecting asymptomatic COVID-19 in trauma patients.
- Limited sensitivity and low positive predictive value indicate POCUS is not a primary diagnostic tool for this indication.
- Standard PCR testing and personal protective equipment (PPE) are recommended as primary protective measures for healthcare providers.
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