![]() ![]() This is called the heel-and-toe technique, and is a method for steering probes. Pushing the head- or foot-side edge creates an angle between the probe surface and the vessel, which can achieve the optimal Doppler angle. 1 In most patients, the probe surface runs parallel to the common carotid artery (CCA) in its usual position, which allows scanning of the carotid artery without applying pressure. However, to accurately record velocity using color Doppler ultrasonography, the angle must be between 30° and 60°. The ultrasound beam should be perpendicular to the skin, with a linear probe generating a grayscale image. Placing a pillow induces a poor evaluation window for the carotid artery and therefore normally should not be used.Īn adequate acoustic angle is important in obtaining an accurate color Doppler image. The neck of the patient should be relaxed and the chin should be slightly raised. Tilting the face too far from the test site can distort the anatomy or compress blood vessels, especially veins. The optimal position for tilting the head of the patient is approximately 45° away from the relevant artery. However, obtaining right-posterior projections is difficult. This position makes it easy to control the ultrasound probe. The examiner generally uses their right hand to evaluate both carotid arteries. A lateral sitting position is used for most ultrasonography examinations. However, the examiner should be familiar with the practice of using both hands. This position provides an expanded sonic window with a clear view of the carotid artery and allows many ultrasound probing positions. 1 In the overhead position, the examiner sits behind the head of the patient beside the end of the bed and uses both hands in the test. ![]() The examiner can observe the carotid artery from either an overhead or a lateral sitting position. ![]()
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