Set-up

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

Views

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

Scanning

• 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

Subcostal

IVC

Pericardial Effusion

Dilation of atria and ventricles

Dilated right ventricle

Cardiac tamponade

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

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