Basic anatomy indicates that lung often over-lies much of the myocardium, and lung (ie air) is the enemy of ultrasound – it will not pass through it. Therefore, in both parasternal views stay very close to the sternum. Rolling onto the left side also helps, if the clinical condition of the patient allows. A common mistake is to allow the conscious patient to rest their hands above their head. This augments the rib cage capacity and inflates any lung overlying the myocardium, making views more difficult.
Assuming the machine settings are set to the cardiac pre-set, relatively good views should be obtained. During the pulse check view, start a 10 second clip recording. Spend the 10 seconds acquiring the best images possible. During the next 2 minute cycle whilst CPR is on-going, review the images and relay your findings to the team leader.
Learning bite
Els requires the acquisition of a sub xiphoid view, plus one other cardiac view, together with an assessment of the ivc