Example 2: Parasternal view, Midclavicular line

This is an example of a Parasternal view of the heart and the key point here is that there is a slight anechoic area but it does have echoes in it and it disappears distally and this typical of a fat pad, and should not be mistaken for a Pericardial effusion.

This is a series about the use of Point of Care Ultrasound in Interrogation of the Thorax, specifically looking for Pneumothorax, Alveolar Interstitial Syndrome and Pleural effusion.

Begin by selecting a probe; generally the high frequency linear probe is going to be best for interrogating the Pleural line. Identify the indicator which we can confirm by using a small amount of gel; this should correspond to the left side of the screen as it is viewed. Generally the indicator will equate towards the patient's head.

And here we are placing it on the patient, again with the indicator towards the head. We are in the Midclavicular line just lateral to the Sternum and we can slide up and down a little bit to get in between the rib shadows.

Here we see the image on the screen. Again the indicator is towards the head, the face of the probe is on the skin. You can see subcutaneous fat. The rib, rib shadow and at the post sterile part of the rib is the Pleural line which is visualized by a shimmering or sliding. This is normal sliding at the Pleural line.