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The transducer indicator should be directed toward the left in a cardiac preset.
With the transducer indicator pointing to the patient’s left, the transducer is placed inferior to the xiphoid process and directed cephalad toward the left shoulder in a horizontal/near coronal plane (see Fig. 24.32).
Pivot, sweep, and tilt the transducer as needed to view all four cardiac chambers.
Identify the heart, four cardiac chambers, and surrounding pericardium (see Fig. 24.33).
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Pericardial effusion: Pericardial fluid will appear as an anechoic (black) region noted between the pericardium and the right ventricle. As more fluid collects, the fluid will be seen completely surrounding all four chambers of the heart. Occasionally, internal echoes representing fibrin, clot, or cardiac tissue may be present within the pericardial space (Fig. 24.34).
Asystole: No cardiac activity present.
Hyperdynamic cardiac activity: Extensive cardiac contraction with near-total or complete collapse of the cardiac chambers, often associated with tachycardia and hypovolemia.
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See “Pearls” for the “E-FAST Examination, Subxiphoid View.”