Pearls & Pitfalls for Ultrasound of Hypotensive Patients 1.
Start with the heart. Parasternal images tend to give the most
information, but the subxyphoid view may be easier in some
patients. Look for effusions, chamber dilation, and wall motion
abnormalities (advanced). 2. Use the curvilinear probe or the
phased array transducer. Start in the 4th intercostal space and
position the probe between the ribs. If you do not get a good
image try moving up or down one rib space and redirecting the
angle of your probe. Remember to direct the beams of your probe
through the long axis of the heart. If you need to decrease the
distance between the patient’s heart and the ultrasound beams,
have the patient roll over onto their left side and bring their
heart closer to their chest wall. 3. Take the time to adjust
your depth and gain to maximize image quality. Make sure you
have enough depth to look behind the heart for a pericardial
effusion. You should always try to see the cross-sectional
descending aorta coursing behin