Adult vs. Pediatric Exam

Adult Exam                                         Pediatric Exam

1 Transducer                                   Multiple Transducers

4 Standard Windows                        4 Standard Windows

Multiple Imaging Planes            Add.Non-standardWindows

Short Image Clips                       Multiple Imaging Planes 

Focus on LV Function/Wall Motion      L/R Determination

                                                       Long Video Sweeps

                                                        Focus on Anatomy

                                                          and Blood Flow

Pediatric Transducers

• Specific to patient size.
• 10 mHz for premies (400 grams +) and newborns up to approx. 9 to 10 lbs.
• 7 mHz for newborns (> 10 lbs.) and toddlers.

• 5 mHz for children about 25 lbs. to smaller pre-teen.

• 3.5 mHz for pre-teen and older.
• Start with highest frequency. 

   

Normal Resting Heart Rates

• Newborn infants: 100 - 160 beats per minute.Diastology is difficult/not accurate on newborns due to high HR.
• Children 1 to 10 years: 70 - 120 beats per minute.
• Children over 10 and adults (including seniors): 60 - 100 beats per minute.
• Well-trained athletes: 40 - 60 beats per minute

Quantification and the Pediatric Exam

• Adults have absolute values of mild, moderate, and severe cases.
• b. Pediatrics uses Z scores.
• The more negative the Z score, the smaller a structure is.
• The more positive the Z score, the larger the structure is.
• Pediatric limits are -2 to +2 based on the patient’s BSA (need Height and Weight) where the number 0 is the mean (average) based on research and 95% of those tested were within -2 and +2.
• Simulates a bell curve

Pediatric Protocol

1. Situs View
2.  Subcostal Long Axis
3. In Between View 
4. Bicaval View
5. Subcostal Short Axis
6. Parasternal Long Axis
7. Parasternal Short Axis
8. Coronary Artery View
9. High Left Parasternal View
10. Apical 4 Chamber
11. Apical 5 Chamber
12. Suprasternal Notch Short Axis
13. Suprasternal Notch Long Axis
14. Ductal View
15. Right Sternal Border