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Normal Adult Echocardiogram Illustrative Protocol

69 element protocol

Average time per element 17 seconds Total time required per study 30 minutes

Pre Scan Procedure:

1. Check the chart for verification of orders and the name of the primary physician.

2. Bring the patient back to the exam room and have them undress and put on gown.

3. Determine through verbal questioning of the patient where the result of the test should be sent.

4. Have the patient lie down on the echo bed; drape female patients appropriately with a towel.

5. Place disposable ECG electrodes on the patient in a modified lead 2 position and attach the ECG cable.

6. Input patient information into the ultrasound system. 7. Position the patient and obtain the views and data as illustrated below in

the order illustrated below. Parasternal Long Axis:

1. 2D left heart (loop)

2. 2D measurements of the IVS, PW & FS (still image)

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3. Zoom MV (loop)

4. Zoom LVOT and AV (loop)

5. Measure LVOT diameter (still image)

6. Measure ascending aorta diameter (still image)

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7. M-mode measurements of AO & LA (still image)

8. M-mode MV. No measurements (still image)

9. M-mode LV. No measurements (still image)

10. 2D RV inflow view (loop)

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11. 2D RV outflow view (loop)

12. Color Doppler MV (loop)

13. Color Doppler AV (loop)

14. Color Doppler RV inflow TV (loop)

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15. CW Doppler TV. Measure TR (still image)

16. Color Doppler RV outflow PV (loop)

17. CW Doppler PV. Measure end diastolic PI gradient (still image)

18. PW Doppler PV. Measure peak gradient (still image)

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Parasternal Short Axis: 1. 2D aortic valve level (loop)

2. Zoom AV for cusp identification (loop)

3. 2D mitral valve level (loop)

4. 2D mid papillary level (loop)

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5. 2D apical LV level (loop)

6. Color Doppler AV level (loop)

7. Color Doppler TV (loop)

8. CW Doppler TR peak gradient (still image)

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9. Color Doppler PV (loop)

10. Color Doppler MV (loop)

11. Color Doppler atrial septum (loop)

Apical 4 Chamber:

1. 2D (loop)

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2. 2D Zoom of LV (loop)

3. Measure EF by Simpson method (still image)

4. LA Bi-plane volume measurement (still image)

5. Measure RVd and RAd. (still image)

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Apical 2 Chamber: 1. 2D (loop)

2. 2D Zoom of LV (loop)

3. Measure EF by Simpson method (still image)

4. LA Bi-plane volume measurement (still image)

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Apical Long: 1. 2D (loop)

2. Color Doppler MV. (loop)

3. Color Doppler and PW Doppler AV/LVOT (loop and still image)

Apical 2 Chamber:

1. Color Doppler of MV. (loop)

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Apical 4 Chamber: 1. Color Doppler and PW Doppler right upper pulmonary vein

2. Color Doppler and PW Doppler MV (loop and still image)

3. Tissue Doppler medial and lateral MV annulus (still imges)

4. Color m-mode MV (still image)

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5. Color Doppler IVS and IAS (loops)

6. Color Doppler and CW Doppler of TV (loop & still image)

Subcostal 4 chamber:

1. 2D (loop)

2. Color Doppler of IAS and TV (loop)

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Subcostal Short: 1. 2D at AV level. (loop)

2. Color Doppler of TV, AV and PV. If PI present, CW PV

3. Color Doppler IAS

4. 2D IVC assess size and reactivity

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5. 2D abdominal AO

Suprasternal Notch:

1. 2D long axis. (loop)

2. Color Doppler of descending AO

3. PW Doppler descending AO

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Post Scan Procedure: 1. Have patient dress and give patient post-test instructions. 2. Complete the echo worksheet. 3. Enter the patient into the logbook. 4. Place the chart in the appropriate location for the reading Cardiologist.