Resuscitation Ultrasound (resUS) Resuscitation Ultrasound (resUS)
Resuscitation Point of Care Ultrasound / Ultrasound Basics / Cardiac Windows / Parasternal Long

Parasternal Long

Transducer Placement (Figure 1)

  • Place the transducer to the left of the sternum
  • The indicator bisects the patient’s right clavicle (10 o’clock position)
  • Slightly rock the transducer under the sternum and once under the sternum tilt the face up to open the left ventricle

Image Orientation (Figure 2, Figure 3)

  • Cardiac exams the indicator is displayed on the right of the screen. Note that in abdominal and all other ultrasound imaging it is displayed on the left
  • The indicator is on the imager’s left but displayed on the right of the screen
  • The left atrium, left ventricle, left atrium, aortic and mitral valves are will visualized

Assessments and measurements

  • LV ejection fraction (visual assessment and E-point septal separation)
  • Aortic valve (aortic stenosis and aortic insufficiency)
  • Left ventricular outflow tract diameter (needed for stroke volume and cardiac output measurements)
  • Left atrial size
  • Mitral valve function
  • RV function

Start at the 2-6th rib space, but may be lower and more medial in patients on a ventilator.

Figures and Clips

Figure 1 - PLA Transducer Placement

Figure 2 - Orientation

Figure 3 - Ideal PLA

Clip 1 - PLA with Cardiac Preset

References

Moore, Christopher L., and Joshua A. Copel. “Point-of-care ultrasonography.” New England Journal of Medicine 364.8 (2011): 749-757.