<p begin="00:00:07.406" end="00:00:09.090" style="s2">- [Voiceover] A phased array transducer</p>
<p begin="00:00:09.090" end="00:00:11.818" style="s2">with a cardiac exam<br />type is used to perform</p>
<p begin="00:00:11.818" end="00:00:15.443" style="s2">an Inferior Vena Cava ultrasound exam.</p>
<p begin="00:00:15.443" end="00:00:18.065" style="s2">The Inferior Vena Cava is evaluated</p>
<p begin="00:00:18.065" end="00:00:20.928" style="s2">at the level of the liver and diaphragm.</p>
<p begin="00:00:20.928" end="00:00:23.006" style="s2">The transducer is placed to the right</p>
<p begin="00:00:23.006" end="00:00:24.914" style="s2">of the epigastric midline,</p>
<p begin="00:00:24.914" end="00:00:28.139" style="s2">with the orientation marker<br />to the patient's feet.</p>
<p begin="00:00:28.139" end="00:00:29.684" style="s2">As an alternative approach,</p>
<p begin="00:00:29.684" end="00:00:33.224" style="s2">this exam may be performed<br />using an abdomen exam type</p>
<p begin="00:00:33.224" end="00:00:36.593" style="s2">with the orientation marker<br />to the patient's head.</p>
<p begin="00:00:36.593" end="00:00:39.491" style="s2">The liver, diaphragm, right atrium,</p>
<p begin="00:00:39.491" end="00:00:43.640" style="s2">and Inferior Vena Cava are<br />identified in this view.</p>
<p begin="00:00:43.640" end="00:00:46.020" style="s2">Sweep from side-to-side to differentiate</p>
<p begin="00:00:46.020" end="00:00:49.252" style="s2">the Inferior Vena Cava from the aorta.</p>
<p begin="00:00:49.252" end="00:00:52.603" style="s2">The aorta is thicker walled and pulsatile.</p>
<p begin="00:00:52.603" end="00:00:56.534" style="s2">The superior mesenteric and<br />celiac branches of the aorta</p>
<p begin="00:00:56.534" end="00:00:58.923" style="s2">are identified at this level.</p>
<p begin="00:00:58.923" end="00:01:01.883" style="s2">The Inferior Vena Cava is thin walled</p>
<p begin="00:01:01.883" end="00:01:04.668" style="s2">and changes caliber with respiration.</p>
<p begin="00:01:04.668" end="00:01:06.928" style="s2">The diameter of the Inferior Vena Cava</p>
<p begin="00:01:06.928" end="00:01:11.095" style="s2">decreases with inspiration<br />and increases with expiration.</p>

<p begin="00:00:08.000" end="00:00:09.607" style="s2">- [Voiceover] A phased array transducer</p>
<p begin="00:00:09.607" end="00:00:12.167" style="s2">with an abdomen exam<br />type is used to perform</p>
<p begin="00:00:12.167" end="00:00:15.543" style="s2">the right upper quadrant<br />view of the FAST exam.</p>
<p begin="00:00:15.543" end="00:00:17.461" style="s2">The orientation marker is directed</p>
<p begin="00:00:17.461" end="00:00:19.301" style="s2">towards the patients head.</p>
<p begin="00:00:19.301" end="00:00:23.018" style="s2">The transducer is placed<br />in a long axis orientation</p>
<p begin="00:00:23.018" end="00:00:25.466" style="s2">along the right mid-auxiliary line between</p>
<p begin="00:00:25.466" end="00:00:28.380" style="s2">the 7th to 9th inter-costal space.</p>
<p begin="00:00:28.380" end="00:00:31.659" style="s2">Rotation and oblique<br />positioning of the transducer</p>
<p begin="00:00:31.659" end="00:00:34.326" style="s2">will help eliminate rib shadows.</p>
<p begin="00:00:35.740" end="00:00:39.277" style="s2">To evaluate the entire area<br />of the hepatorenal recess</p>
<p begin="00:00:39.277" end="00:00:41.860" style="s2">for free fluid sweep the transducer</p>
<p begin="00:00:41.860" end="00:00:45.188" style="s2">from an anterior to posterior position.</p>
<p begin="00:00:45.188" end="00:00:47.958" style="s2">If present, fluid will appear as a dark</p>
<p begin="00:00:47.958" end="00:00:51.605" style="s2">or aniconic strip between<br />the kidney and the liver.</p>
<p begin="00:00:51.605" end="00:00:55.078" style="s2">If it is difficult to visualize<br />the hepatorenal recess.</p>
<p begin="00:00:55.078" end="00:00:57.402" style="s2">A deep inspiration will move the diaphragm</p>
<p begin="00:00:57.402" end="00:00:59.322" style="s2">and other structures in this area</p>
<p begin="00:00:59.322" end="00:01:02.882" style="s2">down and below the ribs for easier access.</p>
<p begin="00:01:02.882" end="00:01:05.357" style="s2">Sliding the transducer<br />upward will visualize</p>
<p begin="00:01:05.357" end="00:01:08.194" style="s2">the diaphragm and plural interface.</p>
<p begin="00:01:08.194" end="00:01:11.155" style="s2">Sliding the transducer<br />downward will visualize</p>
<p begin="00:01:11.155" end="00:01:14.405" style="s2">the inferior pole of the right kidney.</p>

<p begin="00:00:07.200" end="00:00:09.566" style="s2">- [Voiceover] A phased array transducer</p>
<p begin="00:00:09.566" end="00:00:11.913" style="s2">with an abdomen exam<br />type is used to perform</p>
<p begin="00:00:11.913" end="00:00:14.758" style="s2">the left upper quadrant<br />view of the FAST Exam.</p>
<p begin="00:00:14.758" end="00:00:16.868" style="s2">The orientation marker is directed</p>
<p begin="00:00:16.868" end="00:00:18.771" style="s2">toward the patient's head.</p>
<p begin="00:00:18.771" end="00:00:22.071" style="s2">the transducer is placed in<br />a long-access orientation</p>
<p begin="00:00:22.071" end="00:00:24.725" style="s2">along the left-posterior axillary line</p>
<p begin="00:00:24.725" end="00:00:28.372" style="s2">between the fifth to<br />seventh intercostal spaces.</p>
<p begin="00:00:28.372" end="00:00:30.923" style="s2">The sonographer's hand<br />will touch the gurney</p>
<p begin="00:00:30.923" end="00:00:33.344" style="s2">with the proper transducer position.</p>
<p begin="00:00:33.344" end="00:00:36.425" style="s2">Rotation and oblique<br />positioning of the transducer</p>
<p begin="00:00:36.425" end="00:00:39.092" style="s2">will help eliminate rib shadows.</p>
<p begin="00:00:43.087" end="00:00:46.518" style="s2">To evaluate the entire area<br />of the spleenorenal recess</p>
<p begin="00:00:46.518" end="00:00:49.173" style="s2">for free fluid, sweep the transducer</p>
<p begin="00:00:49.173" end="00:00:52.423" style="s2">from an anterior to posterior position.</p>
<p begin="00:00:53.723" end="00:00:56.699" style="s2">Carefully examine the spleenorenal recess</p>
<p begin="00:00:56.699" end="00:00:58.567" style="s2">and subphrenic space.</p>
<p begin="00:00:58.567" end="00:01:01.479" style="s2">Fluid will appear dark or anechoic.</p>
<p begin="00:01:01.479" end="00:01:04.925" style="s2">If it is difficult to visualize<br />the spreenorenal recess,</p>
<p begin="00:01:04.925" end="00:01:07.562" style="s2">a deep inspiration will move the diaphragm</p>
<p begin="00:01:07.562" end="00:01:09.580" style="s2">and other structures in this area</p>
<p begin="00:01:09.580" end="00:01:12.581" style="s2">down and below the ribs for easier access.</p>
<p begin="00:01:12.581" end="00:01:15.311" style="s2">Sliding the transducer<br />in an upward direction</p>
<p begin="00:01:15.311" end="00:01:19.478" style="s2">will visualize the diaphragm<br />and plural interface.</p>