How to perform

Inferior Vena Cava (IVC)

How to perform: 

The tank is assessed in two sections. First the inferior vena cava (IVC) is assessed with the phased array probe. Then the abdomen and lung apices are assessed with the curvilinear probe, in the same way as an extended Focused Assessment with Sonography in Trauma (eFAST) scan.

Inferior Vena Cava (IVC)

Probe position: With the probe in the subcostal position, rotate 90 ^o  so the marker now looks to the patient’s head. This image shows the IVC collapsing in inspiration

Image: authors own

Pitfall

The aorta can be mistaken for the IVC in the above view. The easiest way to avoid this mistake is to visualise the RA and follow the hepatic vein draining into the IVC.

Abdomen including Morrison’s pouch

Probe position: A detailed review of how to perform a FAST scan is available in the RCEM Learning Session FAST Scan. You should obtain RUQ, LUQ and pelvic views for the RUSH protocol assessment, looking for free fluid in the peritoneal or pleural cavities, or B lines which suggest pulmonary oedema.

Bilateral apical Lung views

Probe position: The apical region of each hemithorax with the probe marker pointing towards the patient’s head. You should visualise two rib spaces and the pleura between them.

Learning bite

If time allows, the linear array probe will give better resolution when assessing the lung fields.