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The AFAST, having exact clarity to its five acoustic windows, is a standardized, rapid screening test of the abdominal cavity, retroperitoneal space, and pleural cavity, including the pericardial sac, heart, and lung. Even for the novice sonographer, the AFAST examination likely will take no more than 3½–4 minutes. In the previous AFAST chapter, we covered image acquisition and the AFAST target organ approach, examples of typical negative and positive images, pitfalls, and artifacts.

In this AFAST chapter, we will discuss clinical integration of AFAST findings as well as its limitations. Enjoy this wild AFAST ride of patient information that gives evidence‐based information by “seeing” your patient's problem list for a better working diagnosis, a better way to manage bleeding patients, a better way to track effusions, a better diagnostic plan for picking the next best test, and much more.

We will cover the following (Table 7.1).

 The abdominal fluid scoring system in different subsets of bleeding patients including blunt trauma, penetrating trauma, postinterventional, and nontrauma.

 The use of the diaphragmatico‐hepatic (DH) view for pericardial and pleural effusion.

 The use of the DH view for lung pathology along the pulmonary‐diaphragmatic interface.

 The use of the DH view and the caudal vena cava for volume status.

 The detection and interpretation of gallbladder wall edema, the so‐called “gallbladder halo sign,” that is a marker for canine anaphylaxis as well as cardiac conditions in the acute collapse, triaged setting.

 Target organ conditions at respective AFAST views that may be easily recognized as “abnormal” to capture cases otherwise missed without ultrasound.