Introduction to Ultrasound

ULTRASOUND BASICS

OBJECTIVES

  • Overview of how ultrasound works

  • Describe the steps prior, during, and after an ultrasound exam

  • State directional terminology and patient’s position

  • Explain the scanning approach

  • Define the echo texture of an ultrasound image

SOUND WAVES

  • Sound waves consist of mechanical waves that contain compression and rarefaction.

  • Ultrasound is transmitted through a medium.

  • Pulses of ultrasound are generated by a transducer and sent into the patient, producing echoes at organ boundaries and within tissues.

  • These echoes return to the transducer, where they are detected and presented on the screen.

  • Brightness of each dot corresponds to echo strength (amplitude or intensity), producing gray scale imaging.

BEFORE STARTING AN EXAM

AIDET

  1. Acknowledge:

    • Greet the patient by name.

    • Example: "Good morning/afternoon, Ms. Jones. We've been expecting you, and we're glad you are here."

  2. Introduce:

    • Introduce yourself politely.

    • Example: "My name is Susan, and I will be conducting your test today. I am a certified ultrasonographer and I do about six of these procedures a day. The doctors say that my skills are among the best. Do you have any questions for me?"

  3. Duration:

    • Inform them of the waiting time.

    • Example: "Dr. Heart had to attend an emergency. He was concerned about you and wanted you to know that it may be 30 minutes before he can see you. Are you able to wait, or would you like me to schedule an appointment for tomorrow?"

  4. Explanations:

    • Advise the patient what you are doing or will be doing.

    • Example: "The test takes about 30 minutes. The first step is to drink this solution, and we’ll have you wait 20 minutes before we take a blood sample. Would you like to read while you wait?"

  5. Thank You:

    • Foster an attitude of gratitude.

    • Example: "Thank you for choosing Sharp. It has been a privilege to care for you."

AIDET DEMONSTRATION

AIDET - FIVE COMMUNICATION BEHAVIORS

  • Acknowledge

  • Introduce

  • Duration

  • Explanation

  • Thank You

HAND WASHING

  • Importance of hygiene in medical procedures.

HOW TO SAFELY PUT ON AND TAKE OFF GLOVES

  • Proper techniques to prevent contamination.

BEFORE STARTING AN EXAM

  1. Check patient’s history.

  2. Check patient’s lab values.

  3. Check patient’s wristband; ask for birthdates and last name.

  4. Request information from the patient:

    • Symptoms, area of pain, surgical history, exam preparation.

  5. Explain the exam to the patient.

  6. Prep the patient based on the exam to be performed.

PATIENT DEMOGRAPHIC PAGE BEGIN-END

  • Ensure correct patient identification:

    • Ask for two identifications.

    • Check patient’s identification bracelets - Medical Record Number.

    • The demographic page allows input of patient’s information:

      • Your name as the sonographer

      • Exam selection

    • For educational purposes, have the patient's name, a space, then your name on all images.

TRANSDUCER/PROBE SELECTION AND PRESET SELECTION

  • Depending on the exam required, select the appropriate transducer/probe and preset software settings.

    • Transducer types and frequency ranges:

    • 3-5 MHz (Curvature) for Abdominal, GYN, OB, and Deep structures.

    • 2-7 MHz (Linear) for Deep Structures and Intercostal scanning.

    • 10-15 MHz (Linear) for Small Parts (Thyroid, Scrotal, Breast).

SURFACE LANDMARKS

  • Surface landmarks utilized as references when scanning:

    • Medial angle of ribs

    • Lateral angle of ribs

    • Inferior costal margin

    • Iliac crest

    • Midline of body

    • Sternal notch

    • Sternum

    • Xiphoid process of sternum

    • Umbilicus

    • Symphysis pubis

ANATOMIC PLANES

  • Sagittal - vertical plane.

    • Median sagittal plane: Separates the body into left and right portions.

  • Coronal - divides the body into anterior (front) and posterior (back) sections.

  • Transverse - divides the body superior (above) and inferior (below).

    • Cephalic – towards the head

    • Caudal – towards the tail

QUADRANTS

  • The human abdominal cavity is divided into four quadrants:

    • Right upper quadrant

    • Left upper quadrant

    • Right lower quadrant

    • Left lower quadrant