Video showing the IVC target view

Starting from the sub-costal short axis view of the IVC and abdominal aorta followed by counterclockwise rotation of the transducer until a long axis view of the IVC is present on the screen

The diameter of the IVC should be measured at end-expiration 1-3 cm before it merges with the RA just proximal to the hepatic vein

Measurement is done on a 2D image or on an M-mode scan

– The reference diameter is the largest diameter

– Measure as perpendicular to the vessel walls as possible

– Measure at end-expiration

The probe is placed on the skin subcostally

The OM is orientated cranially

The OI is on the right side of the screen

The right atrium will be displayed to the right and the IVC to the left and the liver on top of the screen

By convention, in cardiac ultrasound the orientation indicator is placed on the right side of the screen

The structures identified in FATE position 1, IVC view

Identify:
– Liver
– RA: Right atrium
– IVC: Inferior vena cava
– Lung tissue

To avoid mistaking the abdominal aorta for the IVC:
1) Identify the entry point of the IVC into the RA
2) Pulsation of the vessel will more likely suggest aortic imaging

In radiology and emergency medicine it is general practice to display the IVC as a mirror image

Notice the orientation marker (yellow “V”) is now on the left side of the screen

Familiarize yourself with both ways of presentation

The target view is the IVC long axis image corresponding to the scanning plane indicated on the torso in the picture

As the IVC transects the liver, liver tissue will appear both in the near and far fields

By convention, the orientation marker in cardiac ultrasound is directed cranially

Image obtained from the subcostal 4 chamber view

– Hold the transducer as a screwdriver, prone
– Place it subcostally, slightly to the right of the midline
– OM should be directed towards the patient’s left
– To achieve the correct anatomical alignment, rotate the transducer approx. 20

For this view the transducer can be held as a screw driver, prone, or in any other position that you feel comfortable with

The subcostal IVC view is obtained by placing the transducer in the subcostal position, slightly to the right of the midline

The orientation marker on the transducer should be directed cranially

Memorize the target IVC image before beginning the examination

A schematic drawing of IVC is found at the upper left corner of the extended views on the FATE card

Download the FATE-card here: https://test.usabcd.org/fate-card