Post on 31-Jan-2016
description
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 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