Hi Don:
I don't know if this gets you a lunch , but I scan and teach my students to scan
standing behind the patient who is seated.  The right carotid is scanned with
the right hand and for the left side, the patient and his chair are moved to
face the opposite wall.  The left carotid is scanned with the left hand. This
position allows for excellent range of motion for the patient's neck, no
distended jugulars, and good position for viewing the monitor and reaching the
imager controls.
For those patients who can't sit, however, I scan facing the patient.
Lorraine Pearlman
Manager, Vascular Lab
Staten Island University Hospitla
Staten Island, NY