Top 10 Ways To Prevent Mistakes When Using Ultrasound

10.  Do not forget to plug in the machine and learn to power on the machine BEFORE you go into the patient’s room.  You don’t want to look like an idiot searching all over for the power button on the machine while the patient is waiting for you to start the scan.

Flickr | joelogon

Flickr | joelogon

9.  Make sure the probes are clean and the cords are untangled before you walk into the patient’s room.  You don’t want to waste time detangling cords or cleaning off blood and gel in front of the patient.

8.  Warm the gel bottle before you lather up the patient with it.  If you don’t have a gel warmer, you can place the bottle in a hot water bath (eg. Basin filled with hot tap water).  Just make sure you warn the patient that the gel will be cold.  Apologize profusely and help clean up the gel afterwards.

7.  Don’t push harder on the probe to try to improve your image.  Getting the probe closer to the target organ doesn’t give you a better image.  Add some extra gel, change your angle, and redirect your ultrasound beams to maximize image quality.

6.  Turning up the gain may make your picture brighter, but it will wash out some of the important detail.  You will want to see the difference in contrast between the various structures (e.g. liver and kidney and lung).

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5.  Know where your probe orientation marker is and make sure you point it consistently towards the standard sides (usually towards the patient’s right side or their head).  This will help ensure your image follows the standard orientation and layout for analysis.  This probe marker corresponds to the orientation dot or insignia on the ultrasound screen.  You want others to be able to look at your image and know exactly what you are looking at.

4.  Start your scan with a really broad depth and range.  The more you can see, the better your chances are of clearly identifying important structures and organs.

3. Pan, fan, and tilt the probe slowly around the site where you think the target structure is.  Remember that most of the time, you are scanning live, dynamic processes, so it helps to make small movements and be patient.  The perfect image will eventually come to you.

2.  Refresh your memory with what probes you are supposed to use, what settings you should keep, and the types of images you are scanning for by reviewing the mobile app, SonoSupport, before you start your ultrasound.  Check out www.SonoSupport.com for the latest educational tips and tricks for how you can master point of care ultrasound.  Available for iOS and Android platforms.  Great for medical students, residents, and faculty wanting to improve their point-of-care ultrasound skills.

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1.  Integrate point-of-care ultrasound into your clinical practice and don’t be afraid to ask for help.  Learn from the experts in the field and develop your own scanning styles and novel applications.  The field is still so young and exciting.  We look forward to learning so much from all of you.

 

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Teresa Wu, MD

Dr. Teresa Wu is a graduate of the Johns Hopkins School of Medicine and completed her Emergency Medicine residency at Stanford University. She completed both ultrasound and administrative & simulation fellowships at Stanford University following completion of her residency training. She is currently the Simulation Curriculum Director and an Associate Professor in Emergency Medicine at the University of Arizona, College of Medicine-Phoenix. Dr. Wu also works as an emergency medicine physician and is the Director of Emergency Ultrasound & Fellowships for the Banner University Medical Center-Phoenix. Over her career, Dr. Wu has developed and directed multiple ultrasound and simulation fellowships across the country, and she has served as an honored keynote speaker for numerous international conferences. Dr. Wu’s innovative research and publications have lead to advances in medical simulation, education, and emergency ultrasound. Her point of care ultrasound app, SonoSupport, has been used to develop ultrasound education and curricula throughout the world.