4. eFAST Exam Protocol

Step 2: eFAST Left Upper Quadrant View (LUQ)

eFAST LUQ View: Does my patient have free fluid in the abdomen or left thorax?

LUQ Probe Position and Hand Placement

  • Grasp the linear probe between your thumb and first fingerlike holding a pencil.
  • Orientate the probe indicator towards the patient’s head.
  • Anchor your probe in the posterior axillary line around the 8th intercostal space.
  • You should have your “Knuckles to the bed” since the spleen is fairly posterior.
eFAST Exam Probe Placement – RUQ
“Knuckles to the Bed” for the LUQ eFAST exam view

LUQ Normal View and Structures

  • Using the spleen as an acoustic window, identify the spleenperisplenic space, diaphragm, and the long-axis view of the left kidney.
  • Free fluid in the LUQ is most frequently seen in the perisplenic space (between the spleen and the diaphragm). The reason is that there is a splenorenal ligament limiting the ability of fluid to track in between the spleen and left kidney
  • Mirror Image Artifact is a normal finding, similar to the RUQ, signifying there is an aerated lung above the diaphragm.
  • You may have to move up or down a rib space to identify the structures.
    • Tip: these structures move as the diaphragm contracts and relaxes during the respiratory cycle. Consider asking your patient to hold their breath to keep the desired organs from moving. Also, consider slightly rotating the probe clockwise towards the bed, so that the probe fits better between the rib spaces.
Left Upper Quadrant LUQ eFAST FAST scan Ultrasound - Labeled
Normal LUQ – eFAST exam
LUQ eFAST exam illustration

Leave a Reply

Your email address will not be published. Required fields are marked *