1. Begin by acquiring an apical-5 chamber view and positioning a pulsed wave Doppler (PWD) gate on the ventricular side of LVOT (left ventricular outflow tract), approximately 1 cm from the valve. Make sure the flow through the LVOT is aligned with your ultrasound beam.

2. Within your advanced cardiac measurements, locate the VTI to trace your waveform as depicted in the image below. This will provide you with a VTI measurement, with a normal range being 18-22 cm.

4. Perform a passive leg raise on your patient for 1- minute. This technique can simulate the effect of a 500cc fluid bolus without administering any fluids. Afterward, measure the VTI again. If there is a change of more than 15%, your patient will likely be a fluid responder.