HOW TO SCAN

When you're scanning, be aware how you hold the transducer. Always hold it as close to the face of the transducer as possible and hold it in such a way that you're always using the small muscles of the hand, rather than your forearm muscles. This will allow finer, more graded movements. But it can be frustrating initially when your thenar and hypoethenar muscles ache from the unusual activity.

Always anchor part of your hand to the patient when scanning to create stability

PROBE MOVEMENTS

Although there are several terms and conventions in describing probe movements, there are essentially 4 basic ways that the probe can move. It can:
  • Slide
  • Sweep
  • Rotate
  • Fan
  • Rock

SLIDE

Sliding or translating is when you move the probe across the skin in the long axis with a fixed angle of insonation. For example moving the probe from one rib space to another. It is important to anchor part of your hand to the patient when scanning so as to avoid inadvertent sliding. This is important in most ultrasound but especially in echo as the windows are small and minor changes in hand position can significantly impact your image. 

Sliding is moving the trandsducer across the skin in long axis

SWEEP

Sweeping is when you move the probe across the skin in the horizontal axis with a fixed angle of insonation. For example moving the probe from medial to lateral on the patient. 

ROTATE

Rotation is when you turn the face of the the probe around its long axis, while maintaining the same skin contact (ie no tilting or angling). Like a spinning top, the probe should maintain it's longitudinal position. This is required to switch between different axes eg parasternal long and short axis, longitudinal and transverse. 

Rotating is turning the transducer clockwise or anticlockwise

ROCK

Rocking of the probe is often described as heel-toe movement, sweeping or tilting. It involves rocking the transducer on a fixed axis so that the skin of the patient is moved towards or away from the probe marker. If a structure appears in your image but isn't centred this is usually the movement that is required. As you are looking at the screen this movement will cause the image to move left and right. 

Rocking is where you move the probe away from the skin at the probe marker or non probe marker end

FAN

In terms of probe movements this is the same as rocking, but along the long face of the probe. This will move your scanning plane through the organ being imaged eg anterior to posterior, superior to inferior, base to apex of the heart 

Fanning is where you tilt the probe away from and towards the skin on the long axis of the face

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Describing the Image

REFERENCES

Bahner DP, Blickendorf JM, Bockbrader M, Adkins E, Vira A, Boulger C, Panchal AR. Language of Transducer Manipulation: Codifying Terms for Effective Teaching. J Ultrasound Med. 2016 Jan;35(1):183-8.