Recall the content of the scanning guide on the previous page

Holding the probe in your right hand:
1. Apply gel without touching the footprint of the probe with the gel dispenser
2. Place the transducer on the chest wall where you expect to get the desired image
3. Move your hand in small circles until you recognize any anatomical structures on the screen
4. Then stop circling and optimize the image in only one plane at a time by means of:
– rotating
– tilting
– sliding
the transducer

Never move in more than one direction at a time
When you are familiar with this scanning procedure proceed to the next topic

The subcostal 4-chamber view is obtained from position 1

In this view these cardiac structures can be visualised:
– Left atrium (LA)
– Right atrium (RA)
– Left ventricle (LV)
– Right ventricle (RV)

The subcostal 4 chamber view shows how the image by convention should appear on the screen

Observe the liver lying “above” the heart, and the base of the heart at the left side of the screen, and the apex of the heart at the right side of the screen

The subcostal 4-chamber view is suitable for a quick qualitative evaluation of:
– Pathology
– Wall thickness
– Chamber dimensions
– Bi-ventricular function

You are now familiar with the ultrasound system and the probe and how to optimise the ultrasound image

After testing your new knowledge with a few quiz questions, you are ready to start the lessons about the FATE protocol

The questions will prepare you for the final quiz

TGC is a user controlled selective amplification of signals reflected from particular depths in the tissue

TGC compensates for the depth-dependent attenuation of the ultrasound wave

A typical user control panel is illustrated in the image

The sector angle is important as it affects the frame rate dramatically

A narrow sector angle (width) allows either (1) a higher frame rate (the time required to build the image is reduced by reducing the number of beams for a whole sector) or (2) a better lateral resolution (the line density can be increased).

A higher frame rate increases temporal resolution

A higher line density increases lateral resolution

By using a sector just wide enough to include all relevant details, the capacity of the ultrasound system capacity is best used

A full Basic FATE examination includes images of the heart and pleura obtained from four different positions, or “windows”, in the thorax

From these positions 6 imaging views can be achieved:
– Position 1: Subcostal 4-chamber view
– Position 2: Apical 4-chamber view
– Position 3: Parasternal views: the long-axis and short-axis view
– Position 4: Pleural views. Right pleura and left pleura

This module will give an overview of these 6 imaging views and how to achieve them

At the end of module 4 (position 1) inferior vena cava (IVC) has been added as a service for those of you who want to learn IVC now

IVC is one of the extended views and therefore a part of Advanced FATE

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

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

The OI is on the right side of the screen, and the arc of the sector is displayed towards the bottom of the screen

Connect ECG to the patient in order to generate and save echocardiographic loops

The ultrasound image can be optimised by adjusting different user controls

The most important user controls are:
– Gain
– Depth
– Sector angle
– Time Gain Compensation

These user controls will be explained in greater detail in the next slides

It is important that you become familiar with these user controls on your own ultrasound system so you know how to optimise the ultrasound image in order to improve the diagnostic value of the images