Control and Placement

• Big wheel – Retro/anteflexion
• Little wheel – lateral flexion
• Omniplane – Buttons
• Lots of lubricant on probe
• Secure ETT with fingers of left hand
• Gently insert in midline while distracting jaw with left hand
• Can use laryngoscope if having difficulty
• Hold with right elbow in at side, left hand controlling at mouth

Views

• Aorta – arch and then cross sectional come into view early, can then follow down to stomach
• Mid esophageal 4 chamber – Need to insert past initial view, may need some retroflexion to get aortic valve out of view and true 4 ch
• Mid esophageal 2 chamber – Center on LA/LV and biplane to 90 deg
• Bicaval view – Start mid esophageal 2 chamber and rotate right to find RA and SVC/IVC
• Long axis – Start mid esophageal 4 chamber and biplane to ~ 130 (good view for chest compression quality)
• Transgastric short axis – advance into stomach, probably needs anteflexion