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DReFAST is not just about scanning…
👉 It’s about knowing where people commonly miss life-threatening findings
🧠 THE 4 CORE QUESTIONS
1️⃣ Free fluid in abdomen?
2️⃣ Pericardial effusion?
3️⃣ Hemothorax?
4️⃣ Pneumothorax?
🔥 HIGH-YIELD TIPS & TRICKS
🫀 RUQ (Morison’s Pouch)
🚨 Tip:
Always visualize the inferior pole of the kidney
👉 Small fluid collections often track there first
👉 Missing inferior pole = false negative
🔥 Trick:
If rib shadow blocks view →
Angle probe slightly oblique between ribs
🫁 LUQ (Splenorenal View)
🚨 Tip:
Don’t focus only on splenorenal recess
👉 First fluid often collects between
spleen + diaphragm
🔥 Trick:
Slide probe more posterior & superior than RUQ
🚻 Pelvic View
🚨 Tip:
Longitudinal pelvic view is more sensitive than transverse
👉 Small free fluid is easier to detect behind bladder
🔥 Trick:
Probe too high?
You’ll miss the bladder completely.
Stay close to symphysis pubis.
❤️ Cardiac (Subxiphoid)
🚨 Tip:
If you can’t see heart →
Most common mistake = probe angle too steep
🔥 Trick:
Keep probe almost flat
Aim toward left shoulder
🫁 Hemothorax Trick
🔥 Mirror Image Rule:
Normal lung above diaphragm = mirror image
❌ Loss of mirror image = pleural fluid / hemothorax
🌬 Pneumothorax Trick
Absence of lung sliding?
Think pneumothorax.
But always confirm with:
• Barcode sign
• Lung point
⚠️ COMMON MISTAKES
❌ Missing inferior pole
❌ Probe too anterior in LUQ
❌ Pelvic probe too cephalad
❌ Confusing pleural fluid with abdominal fluid
❌ Ignoring mirror image loss
🔥 CLINICAL PEARL
Negative scan does NOT always mean no injury
👉 Technique matters.
🎯 REAL SECRET
eFAST accuracy often depends more on
probe positioning
than machine quality.
📌 SAVE THIS — these tips can improve your scan immediately.
🔥 FOR SUBSCRIBERS:
Advanced eFAST pitfalls + image interpretation pearls + difficult views breakdown coming separately 🔒
#POCUS
#EFAST
#EmergencyMedicine
#MedicalEducation
#CriticalCare
@dr.vivek24x7
