Discuss ARDMS AE-Adult-Echocardiography Exam Topic 5 Question 8

Which patient body positioning and respiration technique is optimal for obtaining the subcostal view?

CLeft lateral decubitus; knees bent and shallow breathing

ASupine; knees bent and breath inhaled

DLeft lateral decubitus; legs extended and normal breathing

BSupine; legs extended and breath exhaled

Suggested Answer: A

The subcostal echocardiographic view is best obtained with the patient supine, knees bent to relax abdominal muscles, and the patient holding a deep breath at the end of inhalation to lower the diaphragm and improve acoustic window through the subxiphoid area.

Left lateral decubitus position is used for parasternal and apical views but is not optimal for subcostal imaging.

This patient positioning and respiration technique are described in the 'Textbook of Clinical Echocardiography, 6e', Chapter on Echocardiographic Windows and Imaging Techniques20:90-95Textbook of Clinical Echocardiography.

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26 comments · newest first

Mirta 3 months ago

Both are good, but left lateral gives better angles.

Roxane 3 months ago

I prefer the supine position for clarity.

Rosalind 3 months ago

Agreed! It helps with diaphragm movement.

Brande 4 months ago

I think the left lateral decubitus position is best.

Matthew 5 months ago

Really? I’m not convinced that’s the only way.

Kimi 5 months ago

Subcostal view needs deep inspiration too!

Alfreda 5 months ago

I thought lateral decubitus was better?

Elise 6 months ago

Totally agree, supine works well!

Tamra 6 months ago

Best position is usually supine.

Glenna 6 months ago

The subcostal view is best obtained with the patient in a supine position and taking a deep breath. Simple as that!

Fairy 6 months ago

Wait, isn't the subcostal view the one where you tickle the patient's toes and see if they giggle? I'm sure that's the key to getting a good image.

Graciela 6 months ago

Isn't the subcostal view the one where you have the patient do the chicken dance while balancing on one leg? I'm pretty sure that's the right technique.

Gilma 6 months ago

Hmm, I think the patient should be in a lateral decubitus position and hold their breath. That's how I always do it.

Rodrigo 7 months ago

The subcostal view requires the patient to be in a supine position with deep inspiration. Easy peasy!

Ollie 7 months ago

I think it's important to have the patient hold their breath during the scan, but I can't remember if it's during inspiration or expiration.

Kate 7 months ago

I feel like the subcostal view requires the patient to be slightly rotated, but I can't recall the exact positioning details.

Lilli 8 months ago

I remember practicing this, and I believe a deep inspiration helps to get a better view, but I might be mixing it up with other views.

Honey 8 months ago

I think the patient should be in a supine position for the subcostal view, but I'm not entirely sure about the respiration technique.

Lynna 8 months ago

Ah, the subcostal view - I remember this from our ultrasound lab. I think the key is to have the patient lie on their back with their knees bent, and then have them take a deep breath in and hold it. That should give you the best visualization of the liver and gallbladder.

Carylon 8 months ago

For the subcostal view, I believe the patient should be positioned lying on their back with their knees bent. And they'll need to take a deep breath and hold it briefly to get a clear image. I'm pretty confident about that, but I'll double-check my notes just to be sure.

Zoila 8 months ago

I'm a bit unsure about the specifics here. Is the subcostal view best obtained with the patient lying flat, or should they be sitting up? And what about their breathing - should they hold their breath or take slow, deep breaths?

Jolanda 9 months ago

Okay, the subcostal view - that's for visualizing the liver and gallbladder, right? I think I remember something about having the patient take a deep breath to get a good look at those structures.

Rodolfo 9 months ago

Hmm, this seems like a tricky one. I'll need to think through the different patient positioning and breathing techniques that could impact the subcostal view.

Josefa 2 months ago

↳ replying to Rodolfo

Don't forget to have them hold their breath briefly!

Avery 3 months ago

↳ replying to Rodolfo

Yeah, and they should take a deep breath in.

Olga 3 months ago

↳ replying to Rodolfo

I think the patient should be in a supine position.

ARDMS AE-Adult-Echocardiography Exam - Topic 5 Question 8 Discussion