7 Tips to Improve your Ultrasound Technique by Robert Williams — Transcript

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1. 0:05morning for you in Australia or good eat
2. 0:08meat in the UK or something between the
3. 0:10two if you are somewhere else in the
4. 0:11world now in the first option webinar I
5. 0:15did I did a very much abbreviated
6. 0:17version of what I teach them to to vets
7. 0:20in practice I'm basically covering the
8. 0:23physics the overview of ultrasound and
9. 0:25also then giving up getting a basic
10. 0:29image now normally I would move on and
11. 0:31do a full abdominal examination with the
12. 0:33with the vets I was working with but
13. 0:34it's not really practical in this sense
14. 0:36so what I thought I'd do today it is
15. 0:40those past something which I call 7 tips
16. 0:42Charger sound technique improving it and
17. 0:45this is sort of what I've learnt over
18. 0:49the years that I've been doing
19. 0:49ultrasound so now is these things
20. 0:58learning fine motor control examining an
21. 1:00organ fully in 3 views with margins and
22. 1:03being thorough
23. 1:03now those 3 all sort of come combined
24. 1:06together to form you know part of your
25. 1:08technique and why you need to do these
26. 1:11things to be a good ultrasonographer
27. 1:13then we'll cover the stomach which is
28. 1:15anybody who does obstacle note can be
29. 1:18quite challenging at times getting
30. 1:20better views of that and what I'll just
31. 1:22quick briefly go of fna checklist and
32. 1:25then the two things at the end finding
33. 1:27those elusive dream of bands which
34. 1:29something everybody wants to do it seems
35. 1:31to be top of the list when in fact it's
36. 1:33not the easiest things to do and then
37. 1:35we'll cover examine excuse me examining
38. 1:40the liver and is it really that easy so
39. 1:45tip 1 fine motor control this is really
40. 1:50paramount to you being a good
41. 1:51ultrasonographer these because many of
42. 1:53the structures you actually look at can
43. 1:55be less than 5 millimeters in width or
44. 1:57diameter and some can easily be less
45. 1:59than 1 millimeter and then thinking that
46. 2:01particular that their common bile duct
47. 2:02the gall bladder wall adrenals typically
48. 2:06are about 1/2 of a centimeter then
49. 2:08finding the duodenal papilla and then
50. 2:11finding around the proximal ureter which
51. 2:13so you can see from the picture below
52. 2:15there there's a little year
53. 2:17euro surah with that and that's the
54. 2:19Europe getting there now that getting
55. 2:21that picture is not easy and once you've
56. 2:23got it is staying on it is not easy
57. 2:25either lonely fine motor control is
58. 2:28imperatives of to forming a good
59. 2:30examination of the locate these
60. 2:31structures and I find following the
61. 2:34aorta is good practice for your fine
62. 2:36motor control you know this this is what
63. 2:43I do the first thing I do every
64. 2:44examination because doing ultrasounds a
65. 2:48bit like writing or learning a musical
66. 2:49instrument
67. 2:50you need to have practice and practice
68. 2:52to do it but also it's it's a good start
69. 2:55it's like a musician having a little
70. 2:57warmup and for me it just gets my hand
71. 2:59in and mind and body into no band
72. 3:02without I'm trying to do so in lateral
73. 3:04recumbent C within that photograph
74. 3:06you've got the head at the front and the
75. 3:09back at the right and that probe is in
76. 3:12dorsal recumbent C right at the top and
77. 3:14also coddled you and you're looking to
78. 3:17get this view now it is easy most cases
79. 3:20to find part of the aorta but to
80. 3:22actually get it the probe align up like
81. 3:25that it takes a little bit of skill and
82. 3:27practice and time sometimes early in the
83. 3:34morning so that's what yet aiming to get
84. 3:39and that's what you should set your
85. 3:40stores against so that's a
86. 3:46diagrammatically representing what
87. 3:47you're doing is you're trying to get the
88. 3:49probe and I've put it up as a linear
89. 3:52probe there and that's your aorta and
90. 3:54you're looking to get it all straight on
91. 3:56that line there if you dilute looking at
92. 3:58the bottom picture you get it right in
93. 4:00the middle and straight you'll get a
94. 4:03picture like that one on the left hand
95. 4:05side with a black bar right across the
96. 4:06screen now if you're off-center coming
97. 4:11down either side here not only will
98. 4:13obviously the aorta get narrower but
99. 4:16you're gonna get slice thickness
100. 4:17artifacts coming through here so you're
101. 4:19starting a techadon this is in the aorta
102. 4:21so that this is the way to actually
103. 4:25determine what you're doing you wait
104. 4:26you're actually seeing on the screen
105. 4:27when they order doesn't look too clear
106. 4:29so that's what you're aiming to do right
107. 4:32dead center obviously if you're not
108. 4:36quite aligned on the on the aorta you
109. 4:40perhaps will get the picture the back
110. 4:42back of the probe with the back of the
111. 4:44aorta on the right-hand side of the
112. 4:46screen but you loser on the left now
113. 4:48what you've got to do then is hold the
114. 4:50back of the probe and then move the
115. 4:52front of the probe onto the aorta there
116. 4:55so you end up with that straight line
117. 4:57right across the screen if you got it