UMEM Educational Pearls

The suprasternal notch view is a valuable tool for assessing the aorta and identifying signs of thoracic aortic dissection. Proper technique is essential to obtain a clear image and improve diagnostic accuracy. 

Steps to Obtain the Suprasternal Notch View:

Position the Patient: 

Ideally, place the patient in a supine position. 

If the patient cannot tolerate lying flat, the scan can be performed with the patient in an upright position. 

Probe Selection & Orientation: 

Use a phased array probe in cardiac mode

Direct the probe marker slightly toward the patient’s left shoulder (or right hip if using abdominal mode). 

Optimize Patient Positioning: 

Ask the patient to extend their neck to improve visualization. 

Having the patient rotate their head to the side may further enhance imaging. 

Placing a rolled towel under the shoulders can help achieve optimal neck extension. 

Probe Manipulation: 

Angle the probe inferiorly toward the chest. 

Adjust the depth to clearly visualize the aortic arch.

References

Kinnaman KA, Kimberly HH, Pivetta E, Platz E, Chudgar A, Adduci A, Stone MB, Rempell JS. Evaluation of the Aortic Arch from the Suprasternal Notch View Using Focused Cardiac Ultrasound. J Emerg Med. 2016 Apr;50(4):643-50.e1. doi: 10.1016/j.jemermed.2015.12.002.