POCUS for Veterinary ERs: AFAST and TFAST Equipment Checklist

The Scan That Lives at the Bedside

Point-of-care ultrasound has moved from a specialist tool to a routine part of the veterinary ER. The patient is unstable, you need answers in minutes, and the machine comes to the table rather than the other way around. That changes what “being set up” means. It is less about a fixed imaging suite and more about whether everything you need travels with the machine to a crashing patient.

This is a gear and stocking checklist, not a scanning tutorial. How to acquire and interpret the views belongs to training and your clinic’s protocols. What follows is the equipment side: what to have on the cart and how to keep it from scattering.

The Three Protocols You Are Equipping For

Most veterinary POCUS in the ER runs on a small set of standardized exams, grouped together as Global FAST, which combines AFAST, TFAST, and Vet BLUE (FASTVet, Lisciandro). A quick orientation, purely so the equipment list makes sense:

• AFAST, the abdominal exam, was developed by Dr. Gregory Lisciandro in 2005 as a veterinary adaptation of the human FAST technique. It uses four standard views and a fluid scoring system to screen for free abdominal fluid (Vetcetera, AFAST and its abdominal fluid scoring system).
• TFAST, the thoracic exam, looks at the chest for things like pleural and pericardial fluid and pneumothorax.
• Vet BLUE, the lung exam, is a regional, pattern-based look at the lungs.

The reason they matter for stocking is that one patient often gets all three, then gets them again a few hours later. POCUS in the ER is frequently serial. You are not equipping for one scan, you are equipping for the fifth scan at 3 a.m. when the supplies should already be where you left them.

The Core Hardware

Start with the obvious and work outward:

• A portable ultrasound unit, ideally one that rolls and has battery runtime for bedside work.
• The transducer your machine uses for abdominal and cardiac or lung views. Use whatever your unit and your training call for. We are not going to prescribe a probe.
• Acoustic coupling gel, and plenty of it. Running out mid-exam is a small disaster that happens more than anyone admits.
• Isopropyl alcohol as an alternative coupling and cleaning agent.
• Paper towels or gauze for cleanup between patients.

That is the imaging stack. None of it is exotic. The trouble is rarely the machine. It is everything in the next section that goes missing.

The Supply Checklist That Actually Goes Missing

When a focused scan turns up free fluid, the next step is often a sample. The supplies for that are the ones that should already be at the bedside, not across the room:

• Syringes in a range of sizes (3 mL, 6 mL, and 12 mL cover most needs)
• Hypodermic needles in common gauges
• A three-way stopcock for larger-volume drainage
• Sample and collection tubes (EDTA, plain, and culture as your workup calls for)
• Alcohol prep pads
• Gauze and a few clean gloves

You know this list. The problem is never knowing it. The problem is that the syringe is in a drawer in the treatment area, the gel is on a different cart, and the sample tubes are wherever the last person put them down. Every trip away from the patient to fetch one of these is time a critical patient does not have.

Keep It on the Machine

Here is the part most carts get wrong. Plenty of portable ultrasound units have an open probe slot sitting empty, while the supplies that should ride along have nowhere to live on the machine itself.

A FAST scan supply pocket drops into an open probe slot and turns that empty space into onboard storage for gel, syringes, needles, prep pads, and sample tubes. To be clear about what it is: it is a supply pocket, not a probe cradle and not an ultrasound part. It just makes the machine carry its own kit. When the unit rolls to the patient, the supplies come with it, and the next serial scan does not start with a scavenger hunt. We wrote about building that workflow in more depth in our piece on veterinary FAST scan workflow organization.

A Cart-Ready Checklist

Print this, tape it inside a cabinet, restock against it at the start of each shift:

1. Ultrasound unit charged and powered, transducer attached and wiped down
2. Coupling gel, at least one full bottle plus a backup
3. Isopropyl alcohol
4. Syringes: 3 mL, 6 mL, 12 mL
5. Needles in common gauges
6. Three-way stopcock
7. Sample and collection tubes
8. Alcohol prep pads, gauze, gloves
9. Surface wipes for cleaning between patients
10. A home on the machine for all of the above, so it travels as one unit

The exam protocols are what you train for. The stocking is what makes the trained exam fast when it counts.

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This article is for informational purposes only and is not clinical or diagnostic guidance. VetBog products are accessories, not FDA-cleared medical devices. Always follow your training and your facility’s clinical protocols. AFAST, TFAST, and Vet BLUE are trademarks of their respective owners, referenced here for identification under nominative fair use.

Sources

• Vetcetera, AFAST and its Abdominal Fluid Scoring System (development by Dr. Gregory Lisciandro in 2005, the four standard views, and the fluid scoring system). Vetcetera article
• FASTVet, Global FAST publications and references (Global FAST combining AFAST, TFAST, and Vet BLUE, developed by Lisciandro GR). FASTVet publications

Frequently Asked Questions

What is the difference between AFAST, TFAST, and Vet BLUE?

AFAST is the abdominal focused exam, TFAST is the thoracic exam, and Vet BLUE is the lung ultrasound exam. Together they are often run as Global FAST. AFAST was developed by Dr. Gregory Lisciandro in 2005 and uses four standard views with a fluid scoring system.

What supplies should be on a veterinary POCUS cart?

Beyond the ultrasound unit, transducer, and coupling gel, keep aspiration supplies within reach: syringes in a few sizes, needles, a three-way stopcock, sample tubes, alcohol prep, and gauze. The point is to avoid leaving the patient to fetch anything mid-exam.

Is the FAST scan pocket a probe holder?

No. It is a supply pocket. It drops into an open probe slot on the machine and stores syringes, gel, needles, and other bedside supplies. It is not a probe cradle and it is not an ultrasound component.

Why does POCUS organization matter more for serial scans?

Critical patients are often rescanned every few hours. If the supplies live on the machine, each repeat scan is fast. If they are scattered around the treatment area, every scan starts with gathering gear, which adds up across a shift.