Ultrasound Transmission Gel
©Walter Rasmussen, R.D.C.S.
Only a minimal amount of ultrasound transmission gel is usually necessary for echocardiography exams. Ultrasound gel is primarily a coupling medium, eliminating the air space between the transducer and skin. While lubrication of the probe provides easy movement, too much gel will make the probe difficult to hold, will spread to unintended areas and cause patient discomfort because it is wet and chilly. In addition, a drier probe can be used to gently stretch the skin or dig-in to the chest wall. A gel warmer can initially improve patient comfort, but the gel soon cools on the patient’s skin.
Patients with a lot of chest hair will require more ultrasound gel because it is highly absorbent. Hair also attenuates ultrasound energy, sometimes making it necessary to part it at the point where the probe is placed.
Patients with very little subcutaneous fat will require enough ultrasound gel to bridge the gap between the transducer face and the skin. Patients with a bony ribcage and recessed intercostal spaces will require frequent re-application of the ultrasound gel since when it starts to warm on the skin, it looses its cohesion.