WTF is scanning efficiency? It’s improving your image acquisition skills, so you get the right images faster. Why does this matter? Let’s be honest. On a busy shift are you likely to use ultrasound if it takes you awhile to get images…?

Now let’s talk about tightening up your right upper quadrant skills. We scan the right upper quadrant a lot in the ED; kidney, FAST, gallbladder, IVC, pleural effusion, etc. Everyone of these scans can be improved by knowing three simple landmarks. The anterior, mid, and posterior axillary lines are your window to scanning efficiently.

In the anterior axillary line is the gallbladder. In the mid axillary line you’ll find the IVC. In the posterior axillary line is the kidney. Because these three structures are stacked anterior to posterior in this order, you can guide your probe movement accordingly. If you’re looking for kidney and see gallbladder, simply sweep or fan posteriorly. If you’re looking for gallbladder and see IVC, just sweep or fan anteriorly. It’s as simple as that. When you’re looking for a structure, your movements should be purposeful and based on relative anatomy. Now that you know the right upper quadrant’s sonographic organization you can make purposeful movements guided by the surrounding anatomy to get images faster.

Happy scanning!