During a “clean” rotation, the direction of the tail of the transducer should be kept 100% stable

Rotation can be:
– Right = clockwise
– Left = counterclockwise

For rotational instructions we do not make use of a secondary reference point

Example:
To obtain the correct subcostal 4 chamber view, alignment with the longitudinal axis of the heart often requires 10-20 degrees counterclockwise rotation

You will therefore often hear the supervisor saying: “Rotate the probe counterclockwise or rotate the transducer to the left”

Tilting is the most difficult transducer movement to communicate because it can take place in two planes

Tilting can be:
1. upwards or downwards
2. side to side

Reference according to the tail of the transducer and a secondary reference point is important during guidance in tilting of the probe

Example:
To obtain the correct LV parasternal short axis view the probe should often have an inclination with the chest wall of 20-30 degrees

You will therefore often hear the supervisor saying: “Lift the tail of the probe towards the right shoulder of the volunteer or patient”

A terminology to describe the movement of the probe during scanning is important in order to optimise the image

During the workshop it makes it easier for the supervisor to give instructions without touching the probe which is crucial for the novice in order to achieve practical skill

There are many available descriptions of the method of manipulation of the probe

We recommend using:
1. rotation
2. tilt
3. slide

These movements are applicable to all scanning locations

As a novice – always, only move the probe in one direction at a time

During the workshops the supervisors are encouraged to give instructions with reference to the tail of the transducer and a secondary reference point when appropriate

Examples of secondary reference points:
1. anatomical land marks in relation to the volunteer or patient
2. physical land marks like the bed
3. spatial: left/right – upwards/downwards – medial/lateral

When complying with an instruction, never do any movements in other directions

The probe is fitted with an orientation marker (OM)

On the image the OM is indicated by a green arrow

The OM facilitates the correct orientation of the probe on the patient

In FATE and adult cardiac ultrasound, the ultrasound image displays the sector with the two radii diverging from the top of the screen

The orientation indicator is on the right side of the screen, and the arch of the sector is displayed towards the bottom of the screen

The ultrasound image on the screen can be turned upside/down or left/right with user controls