How can you become a well-known ultrasound specialist? A good imaging skill as well as a skilled eye and a vast medical background aren’t enough. Here are some important strategies to assist you in your quest to help you become a master of ultrasound.
1.) Be aware of what you’re trying to find
Imagine that you drop an entire bag of shopping items. Wouldn’t you like to find out what was in the bag initially? This is also true for ultrasound. Of course , one must take an “complete” examination. But do we ever pay attention to every single aspect of the heart even if we’re not looking for something particular?
For instance, it’s easy to overlook this tiny fibroelastoma, if you don’t be aware that the patient experienced an event that involved cerebrovascular blood flow:
My advice is to Talk with your patients, obtain more information from your treating physician, study their medical records and study studies from other imaging modality.
We tend to draw conclusions too quickly. We might see one or two diagnosis and assume that we know what’s happening. However, be aware that statistics’ laws say that the impossible can happen at times.
Here’s an example of this Here’s an example: We discovered a massive mass of pulmonary artery of a patient suffering from deep vein thrombosis chronic hypertension of the pulmonary system and right high heart pressure.
It’s likely that this is a thrombus is that right? But it’s not quite. It was later discovered to be an rhabdomyosarcoma that was growing in the pulmonary blood vessel.
My suggestion: first observe and then give a thorough description (size or location, echogenicity, etc.).) and then make your own interpretation. However, you must also give possible alternative diagnosis. This way, you won’t fall off the track completely.
3.) Don’t be afraid to be unsure
The interpretation of ultrasound findings is generally not a straightforward black and white matter. Keep in mind that “eyeballing” is a crucial role in ultrasound “is the appearance of the organ normal , or is it an internal tumor hiding there?” “Is mitral regurgitation moderate or mild?” “What about regional wall motion disorders?” And most importantly “how do you determine “the” left ventricle functioning?”
A few days ago, I posted this 4-chamber image in Facebook and asked our friends what they thought of the left ventricular function of this patient.
The comments varied from normal to extremely diminished. What’s my view? In truth, I’m not certain either. I would suggest it’s likely to be in the area of moderately reduced. The ventricle exhibits this abnormal motionthat makes it difficult to determine the cause. This precisely what I’d say on the form of the paper. It could read as follows: “Difficult interpretation of LVF due to an abnormal septal movement possibly moderately reduced LVF.
Be wary of terms like “probably”, “could be”, “might be”, “unclear” or “it appears”. I believe that these terms are crucial because they indicate the degree of uncertainty. They may eventually help to create the trust of you as well as your physician who you refer to. Why? Because they prove your honesty.
4.) Ask other people
I frequently do this and everyone requires to get a second opinion or assistance. The power to rely on “collective intelligence” that has led to the rapid advancements in the field of science. It is a good idea to utilize it more often in the field of ultrasound. Here’s a personal example Do you know what the next off-axis subcostal image shows?
I didn’t realize it was happening several years ago until I showed the test to a friend in radiology. He explained to me the characteristics that are characteristic of Polycystic Syndrome. This is exactly what this patient was suffering from. The lesson hereis to ask other people for help and your skills will grow, your work will improve and your coworkers will be more confident in your abilities.
I am aware that it can be sometimes difficult to locate someone to mentor you. Even if there isn’t anyone who can help you, there is the Internet to find numerous forums where you can post your concerns, queries and much more.
5.) Follow up with your patients
Have you encountered this situation? You encounter a patient who has unusual pathology, and you’re not sure what’s. You write about it in your report, and the patient is taken away from the lab and you’re done. You’ve done your job and within a couple of hours, or perhaps a day or two, you’ve lost track of the patient.
One of the biggest errors I observe among the trainees is that they don’t monitor their patients. A lot of them don’t want to discover what transpired out of them, or even what the problem they noticed was. A tumor? Vegetation? Maybe an blood clot? Was the operation carried out as planned? What were the results of autopsy? What was the result of the autopsy?
Sometimes, it is simple to find the answer. Contact the patient for a follow-up test. Here’s an example of a patient with extreme mitral regurgitation, along with extreme pulmonary hypertension. I was wondering what his” LVF truly was before surgery (left).After the MV repair (right) the pressure in the pulmonary artery fell substantially (no “D ventricle shape” no longer) however one can see that the LVF has been deteriorating. This indicates that we did not realize that Left Ventricular Dysfunction was present prior to the surgery. A lower afterload as well as the D ventricle’s shape did not allow us to detect the issue prior to the surgery.
Here’s my suggestion Create the list of patients you have to follow-up with. Set aside a few minutes towards the end of the week , to review the list. Study the outcomes for your clients. Play the role of a detective to stop loop “loop of knowledge”.