Ultrasound Request Form and Safety & Imaging Controls (Video Notes)

Sonographer: performs ultrasound exams, ensures image quality, and provides patient care.
Sonologist: physician who interprets ultrasound studies.
Core duties: obtain and report patient data; knowledge of the ultrasound system; apply universal precautions; deliver quality care.

OSHA framework: engineering controls, work practices, housekeeping, PPE, vaccination.
In ultrasound practice: PPE when needed; probe cleaning with appropriate wipes based on patient condition; follow universal precautions.

Engineering controls: devices/practices that reduce exposure risk (e.g., sterilization methods, needle safety, biosafety precautions).
Work practice protocols: gloves when handling blood/fluids; additional protective gear (gowns) as indicated; proper hand hygiene.
Housekeeping controls: clean equipment, contaminate-free surfaces; proper disposal of sharps and laundry handling.
Hepatitis B vaccination: 3 doses over 6 months; provides protection if exposure occurs, but does not prevent exposure itself.

Always document a exam-specific reason for the study; reason must align with the requested exam to avoid mismatches (e.g., ensure a liver request matches the intended study).
Documentation components: assessment notes, prior lab results, reports of previous ultrasounds, correlating imaging and studies.
Post-scan reporting: describe findings with appropriate language; do not make a diagnosis in the report.

When describing findings, use descriptive terms like: echogenicity, borders, shadows, calcifications, echo patterns (e.g., anechoic, hyperechoic, heterogeneous).
Do not name or diagnose conditions in the report; label structures and characterize them instead (e.g., anechoic cystic structure).
Legal considerations: if something is visible in images but not described in text, maintain documentation and protect yourself with accurate notes; avoid unverified statements in the report.

Common descriptors: homogeneous vs heterogeneous; smooth vs irregular borders; shadows; calcifications; echogenic foci.
Reportable elements: origin/location, number, size, and composition of findings based on echo patterns.

Worklist workflow:
- Verify patient identity (name, date of birth, patient ID) and wristband match.
- Select exam type (OB, abdomen, GYN, cardio, vascular, pediatrics).
- Enter sonographer initials and exam details.
Transducers/probes: select correct probe for the study (e.g., pencil probe for small structures, curvilinear for abdomen, vascular probe for vessels).
Imaging presets: choose appropriate preset as starting point; adjust parameters from there.

Depth: sets how deep the image displays; adjust to optimize visualization.
Gain: overall brightness; increasing gain enhances visibility of echoes.
Frequency: higher frequency for superficial structures; lower for deeper structures.
Time Gain Compensation (TGC): depth-dependent brightness; adjust the TGC curve to balance echoes from near vs far structures.
Focal zones: position and number of focal points to sharpen resolution at the area of interest.
Annotations: use preprogrammed annotations when available; you can erase or edit as needed.

Dual image / image direction: compare two images side by side; adjust display direction as needed.
Freeze: freeze real-time imaging to capture a still image for review.
Cine loop: store a short sequence of frames (a motion clip) for review and teaching; useful for dynamic processes.
Print/store: save frozen images to the system or print as needed.
Cineloop: review recently scanned frames; similar concept to a short video recording.

Be precise and cautious: describe what you see, avoid diagnosing; use terms like "fluid-filled structure" instead of calling it a cyst when appropriate.
Protect yourself: document interactions or issues with coworkers; maintain personal notes for legal protection.
Proficiency focus: master vocabulary and reflexively apply safe, evidence-based descriptions; practice with real images to build confidence.