1) Cardiac

• general criteria for all clips:
• indicator mark on screen right for all clips
• all files should be clips rather than still images

Parasternal long-axis

• axis:
• following structures visible: LV, LA, RV, LVOT, aortic valve, mitral valve
• functional finding: 
• aortic & mitral valve both seen opening @ appropriate part of the cardiac cycle
• gain: 
• blood is either grossly anechoic (black) or mostly anechoic with just a few specks of grey
• depth: 
• able to see at least descending thoracic aorta

Parasternal short-axis

• axis:
• following structures visible: LV @ mid-ventricular level, RV
•  gain: 
• blood is either grossly anechoic (black) or mostly anechoic with just a few specks of grey
• depth: 
• able to see deep enough to visualize parietal pericardium

Apical 4-chamber

• axis:
• following structures visible: LV, RV, RA, LA, mitral, tricuspid
• functional finding: 
• tricuspid & mitral valves both seen opening in diastole 
• gain: 
• blood is either grossly anechoic (black) or mostly anechoic with just a few specks of grey
• depth: 
• able to see deep enough to see just posterior to the atria

Subcostal 4-chamber

• axis:
• following structures visible: LV, RV, RA, LA, tricuspid, (optional = mitral)
• functional finding: 
• tricuspid valve seen opening in diastole 
• gain: 
• blood is either grossly anechoic (black) or mostly anechoic with just a few specks of grey
• depth: 
• able to see deep enough to just posterior to parietal pericardium deep to the LV

IVC long-axis

• axis: 
• following structures visible: IVC (NOT aorta or hepatic vein) in long-axis, liver
• gain: 
• blood is either grossly anechoic (black) or mostly anechoic with just a few specks of grey
• depth: 
• able to see deep enough to see behind the IVC to see if there is liver tissue or spine there (i.e., if liver posterior to IVC, this supports the identification structure as IVC whereas if spine is posterior, supports identification of this structure as aorta)

2) Lung

• general criteria for all clips:
• indicator mark on screen left for all clips
• all files should be clips rather than still images

anterior or antero-lateral lung view

• axis:
• cranial & caudal ribs/rib shadows visible
• should be able to visualize whether lung sliding is present or absent
•  depth:
• if B-lines are visible, screen depth should be enough to see the B-lines obliterate at least 2 A-lines (typically at least 10cm)
• if only A-lines are visible, one only needs enough screen depth to visualize the first A­ line
• gain:
• gain should be low enough to see pleural line distinct from surrounding structures

postero-lateral lung view

• axis:
• should be able to see the following structures: diaphragm, spine caudal to the diaphragm, supradiaphragmatic space
• depth:
• should be set deep enough to see the spine 
• gain:
  
• gain should be high enough to see liver/diaphragm as having medium (tissue-like) echogenicity (i.e., liver/spleen should NOT be completely anechoic)

3) Gastric

• general criteria for all clips:
• indicator mark on screen left for all clips
• video clips are preferred but still images will be considered if they are of high-quality
• need to include both a supine and a RLD clip for purposes of the supervised portion of the portfolio (note: in routine clinical practice, the RLD view can be skipped if the supine shows either solids or a grossly distended antrum)
• axis: 
• should be able to see the following structures: 
• liver, antrum in full circumference, aorta (exception when there is recent solid intake in which case the aorta may be obscured by air artifact in the antrum)
• depth: 
• should be set deep enough to see the aorta, or where it aorta expected to be
• gain: 
• should be set so that the liver appears of medium echogenicity (grey) and the content of aorta appears anechoic

4) Abdominal free fluid / Focused Assessment with Sonography in Trauma (FAST) exam

• general criteria for all clips:
• indicator mark on screen left for all clips
• video clips are preferred but still images will be considered if they are of high-quality

Right Upper Quadrant (RUQ) / Morison’s Pouch view

• axis: 
• diaphragm, hepato-renal recess (Morison’s pouch), and inferior tip of liver are visible
• depth: 
• deep enough to visualize spine, but not beyond spine
• gain: 
• should be appropriate to allow visualization of free fluid as distinct from surrounding tissues

Left Upper Quadrant (LUQ) / Spleno-renal recess view

• axis: 
• diaphragm, spleno-renal interface, and inferior tip of spleen are visible
• depth: 
• deep enough to visualize spine, but not beyond spine
• gain: 
• set to allow visualization of free fluid as distinct from surrounding tissues

Pelvic view: transverse

• axis & depth:
• male pelvis: entire bladder is visualized.  Seminal vesicles and/or prostate is visible.
• female pelvis: entire bladder is visualized. 
• gain:
• set low enough to permit screening for free fluid posterior to the bladder

Pelvic view: sagittal

•  axis & depth:
• female pelvis: bladder, uterus (if present), and vaginal stripe are visualized. 
• male or female, if bladder distended: maximal size of bladder visible (i.e., anterior-posterior dimension of bladder similar in this view to the maximal anterior-posterior dimension of bladder seen in accompanying transverse view)
• gain:
• set low enough to permit screening for free fluid posterior to the bladder