SDEP® CARDIAC PRE-ANESTHETIC SCREENING PROTOCOL
This cardiac screening exam is intended for patients undergoing necessary procedures such as, but not limited to, dental cleanings/extractions, minor surgical interventions (e.g., laceration or wound repair), or other procedures requiring general anesthesia.
NOTE: The screening exam is not appropriate for patients with an auscultated congenital murmur. Such patients should undergo complete and comprehensive echocardiographic examination.
OBJECTIVE: To equip the general practictioner with a quick, efficient method for assessing cardiac function prior to inducing anesthesia. To evaluate evidence of pressure overload or volume overload that would influence anesthetic risk.
GENERAL PRACTITIONER: The sonographer must be trained in SDEP® Echo and must be able to obtain quality, 3-second videos of all positions in the SDEP® Echo.
EQUIPMENT: The ultrasound machine must be capable of acquiring and storing high-quality cardiac images. Cardiac measurements are not necessary. For optimal efficiency, images should be sent directly from the ultrasound machine to SonoPath (see SonoPath Screening Submission Instructions, final page).
Six videos minimum / Ten videos maximum.
This protocol is for pre-anesthesia cardiac screening only and not considered a full echocardiogram.
If the specialist finds concerning pathology, then the specialist will indicate the need for a complete SDEP® or equivalent echocardiogram.
A brief global assessment report and 2–4 representative images is provided by our experienced and Boarded specialists (ABVP, Internal Medicine-Cardiology, DEVCC).
SDEP® SCREENING PROTOCOL
CARDIAC IMAGES
SDEP® Echo is a 3-second cine loop approach in a 7-point protocol to optimize and evaluate every region of the heart from acquired to congenital disease. The positions below are specifically selected from this protocol for pre-anesthetic cardiac screening.
SDEP® Position 1:
Right Parasternal Long Axis “The Brick”
- Starting at the axilla, slide caudally and dorsally, keeping the probe tail cranial
- Twist to lengthen to capture a long 4-chamber view
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Canine
Feline
Canine
Feline
SDEP® Position 1:
Long Axis 4–5 Chamber Efficiency Clip
Twist and tilt slightly to get this view
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Canine
Feline
Canine
Feline
SDEP® Position 1:
Short Axis Heart Base “Mercedes”
Start with 5-chamber in long axis & twist to short axis
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Canine
Canine
SDEP® Position 1:
Short Axis Sweep Heart Base to “Mushroom”
- Heart base
- Fish lips
- Mushroom
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Short Axis Sweep:
Heart Base to “Mushroom”
1. Heart base
2. Fish lips
3. Mushroom
SDEP® Position 3:
Right Auricle
- Left side of chest, adjacent to the sternum
- Compress the lung
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Canine
Canine
SDEP® Position 4:
Apical View
- Use the back of the hand to gently compress the diaphragm,
- Flatten the probe against the abdomen
Provide one, clean, high-quality 3-second cine loop.
Important: Use a smooth motion to capture a clean video.
Canine
Canine
Images to Submit:
Submit ONE cine loop of each of the following:
Cine Loops: 6
Still Images: 0
Position 1: Right Parasternal Long Axis (“Brick”)
Position 1: Long Axis 4–5 Chamber Efficiency Clip
Position 1: Short Axis Heart Base (“Mercedes”)
Position 1: Short Axis Sweet (Heart Base to “Mushroom”)
Position 3: Right Auricle View
Position 4: Apical View
Notes:
- Each cine loop should be obtained and submitted using high-quality imaging technique, adhering to the standardized SDEP® Echo positions outlined in this preanesthetic protocol.
- Each cine loop should have a duration of three seconds.
- An additional 1–4 cine loops may be submitted for some patients if needed.
To submit for an SDEP® Cardiac Pre-anesthetic Screening Report:
- Telemed Accounts: Go to your SPA login – Website spa.sonopath.com/user/login
- Go to “Upload a Case”
- Interpretation Type: Select “Ultrasound”
- Ultrasound Type: Select “Pre-anesthetic cardiac screening” (this is not a full echo)
- Choose “Dr. Lindquist”, “Dr. McDaniel”, or “Dr. Harris”
- Continue with the other information required
- Submit
Send images to SonoPath from your ultrasound machine to:
Name: Sonopath Cloud
AE Title: SONOPATH-4
IP Address: 3.135.60.57
Port: 4242
Compression: JPEG
Please note, your image set must only be submitted once.
Questions? Please contact Danielle Nieman: [email protected]