Place cardiac probe flat on the abdomen (hand above the probe) + and slide towards xiphoid until visualize the heart.
Center the heart on screen + visualize the "7" (the full right ventricle free wall (superficial) + inter-ventricular septum.
Fan through the heart anteriorly and posteriorly, examine for fluid.
Assessment:
Pericardial effusions (anechoic black fluid) will first be seen in near field in posterior area.
Note: epicardial fat pads = strips of fat around the heart can look similar to effusions but they will appear anteriorly (whereas effusions are seen first posteriorly) and fat pads have some white stranding and aren't fully anechoic.
Hepatorenal/Splenorenal Pouch Assessment
Locate xiphoid process, place curvillinear probe on abdomen preset at posterior axilary line on either right or left side.
Can rotate probe between ribs to better visualize liver/spleen. Locate kidneys on both sides.
Fan anteriorly and posteriorly through the interface between the spleen/kidney or liver/kidney.
Note: need to visualize the tip of the liver edge and need to visualize the full area of contact between the spleen/kidney and liver/kidney.
Assessment:
Look for anechoic fluid in hepatorenal or hepatosplenic area.
Bladder Scan
Place curvilinear probe in transverse orientation (probe marker to patients right) right above symphysis pubis (this is very low down).
Identify bladder + fan through it.
Rotate probe to longitudinal view + again fan through.
Assessment:
Look for anechoic fluid surrounding the bladder in pelvis.
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