Communication, Reporting, Patient Safety & Exam Prep

Communication: Verbal vs. Non-Verbal

  • “Pie chart” breakdown: non-verbal cues ≈ (65\%) of total message perceived by patients.

  • Key non-verbal behaviors to AVOID

    • Rudeness, ignoring the patient, judgmental expressions.

    • Rushing the procedure, typing while the patient talks, looking away.

    • Closed posture: crossed arms, turned body, lack of eye contact.

  • Desired provider manner

    • Open, relaxed posture; active listening; appropriate facial expression.

    • Sets the emotional "stage" for a successful examination.

Barriers to Therapeutic Interaction

  • Rudeness toward anyone (patient, staff, family).

  • Ignoring or dismissing patient concerns.

  • Judgmental comments or non-verbal signals.

  • Haste (rushed explanations or maneuvers).

Sonographic Reports

  • Core components

    • Patient demographics: name, DOB, MRN, sex, referring physician.

    • Pertinent history & indication: symptoms, prior imaging, relevant personal/family history.

    • Comparison with prior ultrasounds, CT, MRI, X-ray when available.

  • Distinct from full patient chart: focuses only on data that influence the imaging interpretation.

CPT vs. ICD-10 Coding

  • CPT (Current Procedural Terminology)

    • Describes the exact PROCEDURE performed.

    • Drives billing for services: e.g. breast US, thyroid US, carotid duplex.

  • ICD-10 (International Classification of Diseases)

    • Describes the DIAGNOSIS/indication.

    • Examples: palpable neck mass, abnormal bleeding, flank pain, history of stones.

  • Workflow: provider supplies both codes; patient hands form to front desk for scheduling further diagnostics.

Patient Reactions to Illness & Maslow’s Hierarchy

  • Eight major coping tasks tie back to Maslow’s pyramid:

    • Physiologic needs → safety → love/belonging → esteem.

  • Awareness helps sonographers anticipate anxiety, denial, dependency, anger, etc.

Learning vs. Cramming

  • Cramming ⇒ short-term memory only.

  • Long-term retention needs

    • Attention: focus & interest.

    • Organization: logical structure for retrieval.

    • Association: linking new facts to known concepts.

    • Adequate rest & nutrition.

  • Required assignment (overview)

    • Describe TWO memory techniques used so far.

    • Provide concrete examples of material learned with each.

    • Explain why each technique works for you.

Common Memory Techniques Mentioned

  • Acronyms (e.g. LESSON for pathology description).

  • Mental imagery / prediction ("see the knob change before you turn it").

  • Others you may have: flashcards, spaced repetition, concept maps, teaching peers.

Patient Safety & Transfer Mechanics

  • General principles

    • Ask before assisting; never assume ability.

    • Lower exam bed, lock wheels, clear floor hazards, ensure footwear.

  • Sliding transfers

    • Two-person technique, use draw-sheet/chuck.

    • Lock both surfaces before lateral slide.

  • Wheelchairs & stretchers

    • Always lock wheels before ingress/egress.

  • Protect YOUR body: proper ergonomics, request help for heavy moves.

Tubing & Devices in Imaging

  • Urinary catheters

    • Never kink, pull, or let the bag rise above bladder level.

    • Communicate with nursing if taping interferes with probe position.

  • Oxygen / ventilatory tubing

    • Avoid dislodging, kinking, occluding.

    • Offer non-verbal communication options for dyspneic patients.

Standard Precautions & Hand Hygiene

  • “Five Moments” apply to ALL patients: wash IN, wash OUT (patient should witness both).

  • Isolation signage outside room specifies PPE, goal (protect patient vs. protect staff), and steps for entry/exit.

Medical Terminology Basics

  • Word parts

    • Prefix – modifies root (location, quantity, status).

    • ROOT – core meaning (organ, condition, procedure).

    • Suffix – describes process, specialty, disorder.

  • Strategy for matching exams: decode unfamiliar terms by parts.

HIPAA & Social Media

  • Never mix: any post (even deleted quickly) is potentially permanent/shareable.

  • "If in doubt, leave it out." Applies to clinical sites AND educational program info.

Medical Law & Ethics

  • Medical law: community/enacted rules binding practitioners.

  • Ethics: study of right vs. wrong in medical practice.

  • Intentional torts: assault, battery, invasion of privacy, false imprisonment, slander, libel.

  • Negligence framework

    1. DUTY – perform to accepted standard.

    2. BREACH – failure to exercise reasonable care.

    3. CAUSE – injury directly results from breach.

    4. INJURY – actual harm sustained.

Work-Related Musculoskeletal Injuries (WRMSI)

  • Risk factors

    • Repetitive motion without breaks.

    • Excessive reach from patient or controls.

    • Improper monitor height/angle → neck strain.

    • Lifting/assisting beyond safe mechanics.

    • Frequent heavy equipment moves.

  • Prevention

    • Stretch/warm-up, vary tasks, optimize chair/bed height,"neutral" wrist and shoulder angles.

Emergency Preparedness

  • Must know before emergencies:

    • BLS procedures (CPR, choking relief, AED use).

    • Location of crash cart, fire extinguishers, exits.

    • Whom to call (code numbers, rapid response, security).

    • Responsibility for patient safety during event.

Administrative / Matching-Style Concepts (Sample)

  • Insurance carrier → Payer (A).

  • Extensiveness of procedure → Complexity (D).

  • Chief complaint → Reason for visit (F).

  • Claim form identifying service & amount → Bill (B).

  • Universal system for procedure/diagnosis → CPT & ICD (C).

  • Disease identification → Diagnosis code (E).

  • Provider → Physician / imaging center / hospital (G).

Contrast Media Basics

  • Purpose: enhance visibility of target structures.

  • Major agents

    • Barium (GI), iodine (vascular/CT), gadolinium (MRI), microbubbles (US).

  • Delivery routes: oral, rectal enema, IV, intra-arterial, others.

Sonographic Descriptive Terminology

  • LESSON acronym for pathology reports

    • L – Location (organ/lobe)

    • E – Echogenicity (anechoic, hyperechoic, isoechoic, echogenic, etc.)

    • S – Size (measure or state "requires measurement")

    • S – Shape (round, oval, crescent, irregular)

    • O – Other characteristics (posterior shadow, enhancement, wall, septations, calcifications, vascularity)

    • N – Number (single, multiple, clustered)

Echo-Texture Terms

  • Anechoic – completely black, no internal echoes (e.g. normal bile).

  • Echogenic – very bright white (≈ bone, diaphragm).

  • Hyperechoic – brighter than reference tissue.

  • Hypoechoic – darker than reference tissue.

  • Isoechoic – same brightness as reference.

  • Homogeneous – uniform texture (normal testis).

  • Heterogeneous – mixed / irregular echoes (pathologic testis).

Applied Examples Discussed

  1. Right liver lesion

    • Echogenic/hyperechoic compared to hepatic parenchyma.

    • Round; single; “needs measurements.”

  2. Testicular images

    • Right image → homogeneous.

    • Left image → heterogeneous.

  3. Sagittal gallbladder

    • Normal lumen = anechoic.

    • If echogenic focus seen: describe echogenicity, posterior shadow, shape, mobility with LLD, singular vs. multiple—NO diagnosis.

Final-Exam & Course Logistics

  • Review all study guides, weekly quizzes, and the Week-1 announcement that lists descriptive terms—highly testable.

  • Verify EVERY grade (Week 1 – Quiz 11) before taking the final; grades cannot be altered afterward.

  • Instructor’s closing advice: steady study schedule, not cramming; reach out for any grading discrepancies.