Standard Echo Protocol Sample
At my externship site, protocols are done here on GE's Vivid E9 & Vivid Q. Since they offer excellent post processing features and a nice live capture of the heart's structures (by hitting the "image store" button twice)- we usually do additional measurements post-test to save time.
This protocol is in an abbreviated format, assuming that you are well versed in your echo views. I also divided the protocol into (9) sequences that can be followed in numerical order- hoping there's something here to help tweak your "diagnostic" capabilities.
This protocol is in an abbreviated format, assuming that you are well versed in your echo views. I also divided the protocol into (9) sequences that can be followed in numerical order- hoping there's something here to help tweak your "diagnostic" capabilities.
"PLAX" (1)
- 2D image
- M-mode AV, MV, & LV
- "2D M-mode" measurements
+ Diastole:
> RVIDd
> IVSd
> LVIDd
> LVPWd
+ Systole:
> LVIDs
> LA Diam.
- Color on MV
- Color on AO
+ Zoom on AO
> Meas. LVOT
> Meas. AO Diam. (...widest point of Sinus)
- M-mode AV, MV, & LV
- "2D M-mode" measurements
+ Diastole:
> RVIDd
> IVSd
> LVIDd
> LVPWd
+ Systole:
> LVIDs
> LA Diam.
- Color on MV
- Color on AO
+ Zoom on AO
> Meas. LVOT
> Meas. AO Diam. (...widest point of Sinus)
"RVIT" (2)
- 2D image
- Color on TV
+ CW, meas. peak velocity*
*If necessary
- Color on TV
+ CW, meas. peak velocity*
*If necessary
"PSAX" (3)
- 2D images at the MV, LV, & Apex Levels
(..make sure Post. Wall is visualized)
- 2D image of AV Level
+ Color on AO
+ Color on PV
> CW, meas. peak velocity*
+ Color on TV
> CW, meas. peak velocity*
- IAS Zoom, check for shunts
*If necessary
(..make sure Post. Wall is visualized)
- 2D image of AV Level
+ Color on AO
+ Color on PV
> CW, meas. peak velocity*
+ Color on TV
> CW, meas. peak velocity*
- IAS Zoom, check for shunts
*If necessary
"4-CHAMBER" (4)
- 2D image
- Color on MV
> PW on MV
> Meas. E, A, & dec. time
> CW on MV, show peak vel.
- TVI (Tissue Doppler) w/ cursor @ lateral wall:
> 2D Image
> Meas. E'
- 2D "Biplane/Simpson's" method
+ Diastole:
> LV
+ Systole:
> LV, LA
- Color on MV
> PW on MV
> Meas. E, A, & dec. time
> CW on MV, show peak vel.
- TVI (Tissue Doppler) w/ cursor @ lateral wall:
> 2D Image
> Meas. E'
- 2D "Biplane/Simpson's" method
+ Diastole:
> LV
+ Systole:
> LV, LA
"5-CHAMBER" (5)
- 2D image
- Color on AV
+ PW, trace LVOT (V1 for the continuity equation.)
+ CW, trace LVOT (V2 for the continuity equation.)
* With an LVOT meas. from PLAX, you can obtain AVA using the continuity equation.
- Color on AV
+ PW, trace LVOT (V1 for the continuity equation.)
+ CW, trace LVOT (V2 for the continuity equation.)
* With an LVOT meas. from PLAX, you can obtain AVA using the continuity equation.
"2-CHAMBER" (6)
- 2D image (2X, for biplane calc.)
- Color on MV
+ CW, meas. peak velocity*
- 2D "Biplane/Simpson's" method
+ Diastole:
> LV
+ Systole:
> LV, LA
*If necessary
- Color on MV
+ CW, meas. peak velocity*
- 2D "Biplane/Simpson's" method
+ Diastole:
> LV
+ Systole:
> LV, LA
*If necessary
"3-CHAMBER" (7)
- 2D image
- Color on AV
+ CW, meas. peak velocity*
*If necessary
- Color on AV
+ CW, meas. peak velocity*
*If necessary
"SUBCOASTAL" (8)
- 2D image
- Color on IVC
+ Evaluate "sniff" response. Note hepatic vein flow reversal.
- Color between IAS/IVS
+ Evaluate shunts (if any) between chambers.
- Color on IVC
+ Evaluate "sniff" response. Note hepatic vein flow reversal.
- Color between IAS/IVS
+ Evaluate shunts (if any) between chambers.
"SUPRASTERNAL" (9)
- 2D image
- Color on outflow
+ CW, meas. peak velocity*
*If necessary
- Color on outflow
+ CW, meas. peak velocity*
*If necessary
ABBREVIATIONS:
PLAX= Parasternal Long-Axis View
RVIT= Right Ventricular Inflow Tract
(Observing flow through the tricuspid valve. The transducer is "looking down".)
PSAX= Parasternal Short-Axis View
PLAX= Parasternal Long-Axis View
RVIT= Right Ventricular Inflow Tract
(Observing flow through the tricuspid valve. The transducer is "looking down".)
PSAX= Parasternal Short-Axis View
