Hudson Valley CommunityCollege Echocardiography

Protocol

Sarah Burns Kristin Logan Valerie Burdo Kathy IvesJennifer Mesch John Coram Ali

The Echo exam will provide information to

assess, measure, and document overall cardiac

Function.

http://www.stanthonys.org.uk/news.html  

Equipment to be Checked prior to exam

• Proper Transducer

• Examination Table

• ECG wires and electrodes

• Storage Documentation (VCR Tape)

• Transducer gel

• Patient gown

• Sheets

Equipment (continued)

• Towels

• Disinfectant spray

Prior to the Examination

• Obtain patient consent

• Obtain patient’s medical history

• Insure there is a valid signed and dated Physician’s order

• Note the indication for the exam

• (If applicable) Review any previous exams

• Enter the patient identification

Patient Preparation

• Advise patient to remove clothing from the waist up and to change into a hospital gown

• Have patient lie supine• Attach ECG electrodes to the chest• Have patient now lie in left lateral decubitus

position with left arm elevated• Dim the lights

The Exam

www.aimshospital.org/Pages/PedCard/noninvasive.html

Parasternal Long Axis

• 4-5 inter-costal spaces • Index toward right

shoulder• Assess for wall motion• Asses size and

function of RV, LV, IVS, LVPW, LVOT, LA, MV, and

products.medison.co.kr/category/.../sm-3.asp

Parasternal Long Axis

• Color Flow Doppler• Aortic Valve• Mitral Valve

www.vmth.ucdavis.edu/cardio/cases/case11/color.htm

Measurements (2-D or M-Mode)

• Aortic Root• Left atrium• Left Ventricle• Inter-ventricular

Septum• LV posterior wall

www.s2.chalmers.se/research/image/Research/iag_projects.html

Parasternal- RVIT

• Angle inferiorly towards Patients right hip

• Color flow Doppler of TV

• Pulsed Wave Doppler TV

Parasternal Short Axis

• Aortic Level

-document tri-leaflet

-tricuspid valve

-pulmonic valve

-color flow Doppler

-Pulsed Wave Doppler

-M-mode (if app.)

• Mitral Valve Level

-left ventricle wall

motion

-M-mode (if app.)

-valvular motion

Parsternal Short (cont)

• Papillary

-note LV wall motion

• Apex

-note LV wall motion

info.med.yale.edu/intmed/cardio/

imaging/techniques/echo_intro

Apical Views

Apical Location

• Find the Apical Impulse on lower left side of chest

• Place the index toward the patients left side

www.cardiology-houston.com/

Diagnostics/diagnostics.html

Apical 4

• LV wall motion

• Spectral recording of MV

• Spectral recording of TV

• Pulse wave Doppler of MV & TV

• Continuous wave Doppler if necessary

• Color flow Doppler of MV & TV

Apical 5 Chamber

• Interrogate LVOT• Pulse wave Doppler of

LVOT & AoV• Continuous wave

Doppler (if appl.)• Color flow Doppler

www.fvet.uba.ar/hospital/ecocardio/ecocanino.htm

Apical 3 Chamber

• Document LV wall motion

• Color flow Doppler to MV, AoV, and LVOT

• Pulsed wave Doppler to interrogate Aov

www.ctr.columbia.edu/~shahram/research_echo.htm

Apical 2 Chamber

• Document LV wall motion

• Apply Color Flow to interrogate MV

Sub-Costal Views

Sub-costal Location

• Have patient lie on back with knees elevated

• Place transducer below the xyphoid process

• Angle the transducer to the patients left should with index toward the left side of the body

Sub-costal

• Sub-costal Long

-document 4 chambers

-color flow Doppler to assess IAS and IVS

• IVC, Hepatic veins, and abdominal aorta

• Sub-costal Short

-Aortic level

-Mitral

-Papillary

-Apex

Supra-Sternal

• Patient in supine position

• Extend neck• Angle inferiorly

toward the heartAssess ascending and descending

aorta

Color Flow Doppler

Pulse wave Doppler

www.quintemri.com/casestudies_AorticArch.html