Preparing yourself, your patient, & scanning environment
A successful ultrasound session, that being OB-GYN, abdomen, vascular, breast, etc, begins with the Sonographer’s approach.
It is your job to assure that the ultrasound equipment you will be using to perform the study is functioning properly to correctly display pathology if there is and none if there isn’t to your Radiologist.
A faulty machine is capable of displaying false-positives that you may document although, you are scanning the patient live right before your eyes. Or what is worse, this faulty machine may even obscure or hide critical findings needed to properly diagnose your patient.
So first things first, Sono friends!
Check your equipment.
If during a prior study you have noticed something wrong, report it to your supervisor for fixing asap. Make sure you have the appropriate probe, that being curvilinear for Transabdominal OB-GYN and a Transvaginal probe if needed or also ordered by the Physician. It is also important to have the transvaginal probe cover and sterile gel handy. Upon completing the transvaginal study you will need to have your Trophon equipment ready or Cidex set up for sterilization of the probe.
Properly preparing your patient will also allow you to obtain quality images throughout your study.
For instance, for transabdominal GYN or very early OB patients, have them lay flat in the supine position. Keep in mind, this is the magical moment most patients decide to cross their legs, it's like an instinct or second nature. They tend to lay back and boom! They instantly cross their legs. However, “What is wrong with that?” you may ask. Crossing the legs feels very comfortable number one and by nature as a lady you were just taught to “Keep ‘em closed!” by your mama. Nothing wrong with that. Well, let's go back to anatomy class everyone! The problem with that is that all of the female organs are located deep within the pelvic cavity and protected by various pelvic bones. Crossing the legs may narrow the Sonographer’s field of view when the legs are crossed. Therefore, if your patient is able to, have them lay supine with legs uncrossed.
The Sonographer is the most essential component of the ultrasound session.
Yes, you are the most important.
Without you, the machine next to the patient is useless! Always remember that and practice safe scanning by keeping your economics in check.
The number of reported cases of repetitive strain injury related to improper scanning technique is increasing. I can not emphasize enough how serious the issues of operator strain, fatigue, and/or injury are.
Most Sonographers sit to scan OB-GYN patients. However, if the patient's condition doesn’t allow you to sit, you will be just as effective if you need to stand to not strain your body due to patient monitors, room set-up, etc.
Most Sonographer sit to scan OB-GYN patients. However, if the patient condition doesn’t allow you to sit, you will be just as effective if you need to stand to not strain your body due to patient monitors, room set-up, etc.
Transabdominal scanning requires the machine console and patient's pelvic to be at the same height. This positioning, together with correct height selection of your seat, should allow you to access everything needed during your exam without twisting, stretching or leaning. Have the patient positioned on the ultrasound table as close to you as possible to avoid straining as well.
Transvaginal scanning presents many opportunities for straining your body. Therefore, positioning your equipment for this exam is very important as well. Make sure to bring your ultrasound machine further back side by side to the patient's pelvis. Otherwise, your machine and you will be too far up (by the patient's abdomen) and your scanning arm will be over-stretched passed your shoulders and back causing strain and twisting. You really want your scanning scare to always be right next to you or slightly in front.
These preparation tips are just a few of many that your instructors, peers, co-sonographers, etc. will teach you. However, as you are just getting started with OB-GYN scanning, applying these tips while scanning at your clinical will develop great habits that will stick with you throughout your Ultrasound career forever.
I hope this was a great intro to OB-GYN scanning,
Till the next blog Sono Babes!
(Next Blog GYN scanning protocols and scanning tips)
Valerie Acosta, B.S, RDMS, RVT
Lé Bump, Palm Beach