The Great role of perioperative ultrasound is so important that every anesthesia department should have a clear vision and mission in this regard

1. Perioperative
Echocardiography
POCUS
Mansoor Masjedi MD , FCCM
Associate professor , Critical care consultant
Shiraz University Of Medical Sciences
Jan 16th 2020
Shiraz , Iran

3. Important Points :
 Target : Anesthesia residents’ need in POCUS
to feel confident to use learned skills in daily
practice
 Not a didactic course
 To improve your skills & pt care
You will practice so much

9. Types
Transthoracic (standard echo)
1. Left parasternal ( long & short axis )
2. Apical
3. Subcostal
4. Suprasternal
Transesophageal
Intracardiac

10. Standard positions on chest wall are used for
placement of transducer called
“ echo windows”

12. 1.Parasternal Long-Axis View (PLAX)
 Transducer position: left sternal edge
 2nd – 4th intercostal space
 Marker towards Rt shoulder
 Most echo studies begin with this view
 Many structures seen from this view

13. Parasternal long axis view

14. 2- Parasternal Short Axis View (PSAX)
 Transducer@ lt. 2nd–4th intercostalspace
 Marker toward lt shoulder (900clockwise from PLAXview)
 By tilting transducer on anaxis between lt hip &Rt
shoulder, short axisviews areobtained at different levels, from
aorta to LVapex.
 Many structuresseen

16. 3 . Apical 4-Chamber View (AP4CH ; A4C)
 Transducer@ apexof heart
 Marker toward lt shoulder

18. A4C → AP5CH view
 Slight anterior angulation of transducer toward chest wall.
 LVOT can be visualised

19. A4C → Apical 2-Chamber View (AP2CH)
 Transducerposition: apexof heart
 Marker dot : Towards lt side of neck(450 anti clockwise from AP4CHview)
 Goodfor assessmentof LVant.&inf.wall

20. 4. Sub – Costal 4 Chamber View (SC4CH)
 Transducerposition: under xiphoid
 Marker toward lt shoulder
 Position:Supine, headslightlylow ,
feet on bed, kneesslightlyelevated
 Interatrial septum, pericardial effusion

21. 4. Sub – Costal 4 Chamber View (SC4CH)

22. 4. Suprasternal View
• Transducer @ suprasternalnotch
• Markertowards lt jaw
• Position:supinewith neck hyperexrended&headrotates to lt
• Archofaorta

23. Conclusion
POCUS provides structural and functional information
Thequality of an echo is highly operator dependent and
proportional to experience and skill

24. Thank you
Be successful