• Probe: Phased array
  • Mode: Peds Cardiac
  • Starting Depth: 10 cm


  • Parasternal long axis
  • Parasternal short axis
  • Apical 4-view
  • Subcostal
  • IVC


  • PSL- probe marker toward patient’s right shoulder at the 4th intercostal space just left of sternum
  • PSS-Rotate 90 degrees with probe marker to patient’s left shoulder
  • A4-Slide probe down to apex and lower handle toward patient with maker facing 3 o’clock position (should be about nipple line)
  • SC-Move probe under xiphoid with indicator to patient’s left, handle against abdomen and probe directed to left chest to obtain subcostal view
  • IVC-indicator toward patients feet, handle at 90 degrees to bed, rock probe to look up and visualize IVC at juncture with RA

Parasternal Long Axis

Parasternal Short Axis

Apical 4

Assess fractional shortening 
RV/LV ratio
Mitral/Tricuspid valves



Pericardial Effusion

Fluid present between heart and pericardium

Dilation of atria and ventricles

Dilated right ventricle

Cardiac tamponade

Pericardial fluid + RV collapse

Pleural effusion mistaken for pericardial effusion

Fix → Pericardial effusions taper anterior to the descending aorta, whereas pleural effusion extend posterior

IVC mistaken for aorta

Fix → Visualize the IVC entering the right atrium, and locate aorta to left of IVC in abdomen