AFAST in Veterinary Emergency Medicine: Technique, Applications and Diagnostic Relevance

Abstract

The Abdominal Focused Assessment with Sonography for Trauma (AFAST) is a rapid, point-of-care ultrasound technique increasingly utilized in veterinary emergency medicine. Adapted from human medical practices, AFAST is designed to detect free fluid within the abdominal cavity, particularly in trauma patients or those presenting with acute clinical deterioration. Its application enhances the clinician’s ability to assess internal injury swiftly, supporting critical decision-making during initial triage and ongoing patient monitoring. The AFAST protocol involves four standardized sonographic views—diaphragmatic-hepatic, splenorenal, cystocolic and hepatorenal—each offering targeted evaluation of dependent regions where effusion tends to accumulate. The Abdominal Fluid Scoring (AFS) system, based on the presence and quantity of anechoic fluid at these sites, provides a semi-quantitative assessment of intra-abdominal hemorrhage or effusion. The technique has demonstrated high diagnostic sensitivity and specificity, comparable to more advanced imaging modalities, while offering speed, repeatability and non-invasiveness advantages. Beyond trauma, AFAST is valuable in identifying non-traumatic conditions such as hemoperitoneum, pericardial and pleural effusion, ruptured organs and acute anaphylactic reactions. Although its diagnostic utility in cases of penetrating trauma remains under investigation, AFAST remains a reliable adjunctive tool in emergency settings. Due to its simplicity, portability and diagnostic accuracy, AFAST has become an essential component of emergency care protocols in veterinary practice. With continued validation and clinical application, it holds considerable promise for improving outcomes in critically ill animals and optimizing the use of diagnostic resources in emergency and critical care settings.