The pericardium can be visualised sub-xiphisternally or parasternally.

Probe position

It is easier to carry this out using a parasternal view in the left parasternal area. The machine settings need to be changed to limit the view to the area being examined. With more advanced practice, the emergency sonographer will learn to look at the back of the posterior aspects of the pericardial sac and not at the anterior aspects, as in a supine patient this is where fluid will begin to pool earlier.

Learning bite

Pericardial collections will be seen posteriorly at first.

Normal scan: pericardium

Abnormal scans

Pericardial fluid