04/28/2026
Last week we showed you WHY to scan the stomach before you cancel that case.
This week: how.
The BabyBlocks gastric POCUS technique page walks through the entire scan, start to finish. Free. No paywall. Written by Dr. Andrea Gomez-Morad with contributions from Dr. Anahi Perlas.
The short version:
Probe: Linear for kids under 40 kg. Curvilinear above that.
Position: Right lateral decubitus, head up 30-45 degrees. Gravity pulls fluid to the antrum where you can see it. Supine alone misses too much.
Find the antrum: Sagittal plane in the epigastrium, just caudal to the xiphoid. Deep to the left lobe of the liver, anterior to the aorta and SMA. Fan side to side until you get it.
Read the image:
- Empty = “bull’s eye.” Five-layer wall, collapsed lumen. That thick muscularis propria ring is your friend.
- Clear fluid = hypoechoic pool in a distended antrum.
- Solids = heterogeneous echogenicity, hard to see the posterior wall. Unmistakable once you’ve seen it.
Grade it (Perlas system):
Grade 0: No fluid in supine or RLD. Empty. Proceed.
Grade 1: Fluid in RLD only. Small volume, likely baseline secretions. Clinical judgment.
Grade 2: Fluid in both positions. This is a full stomach. Full stop.
For kids, stick with the qualitative grade.
Free at baby-blocks.com.
