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Re: Missing fetusFrom: Terry J DuBose (DuBoseTerryJ@UAMS.edu)Thu Aug 30 08:20:56 2001
It is a plane problem... a plain case of inexperience. I have seen people miss twins, but it is usually early in their sonographic careers (students). I have never missed a twin, and find it incomprehensible that a twin could be missed after about 7 weeks. There was one case reported in The Wall Street Journal of a huge lawsuit (multiple millions $$) in California involving an obstetrician who did his own scanning (without ultrasound specific education) and never did realize there were twins... sometime after delivering one baby, the nurse noticed a hand hanging out of the vagina. The second twin suffered neurological damage. Please do not be offended... I am not saying that physicians, nurses, or anyone else should not scan. I believe the “turf battle” over sonography ended in the 1990’s... in the future almost everyone in medicine is going to be using ultrasound. Sonography is just too valuable and applicable quickly in many situations. However, I do believe that those holding the transducer need appropriate education and I believe that they should demonstrate minimum understanding by taking and passing an examination like the American Registry of Diagnostic Medical Sonography. (http://www.ARDMS.org). The ARDMS exams are the only sonographic certifying examinations (in the USA... world?) that have Category A classification by the National Commission on Certifying Agencies (NCCA)... an independent review and validation process. People want their degrees to come from accredited colleges and universities, we want our students to attend accredited programs, we expect health care professionals to be certified in their professions, but sonography is tending to ignore this time honored tradition of academe. I believe that this is the primary reason that the RADIUS study in the USA got such abysmal results for OB ultrasound... they did not consider the sonographic specific education of the operators. They assumed that if the person was a MD, RN, or RT that they could do the exams... but just knowing anatomy and pathology does not mean that one understands ultrasound imaging. And if our professional luminaries do not sit for an appropriate exam to demonstrate this minimum knowledge, then they are mandating that anyone with a degree equal to their own can perform satisfactorily with ultrasound without sonographic specific education... but that isn’t necessarily so. We should not consider sitting for such an exam as beneath us no matter how high our degree(s), but it should be an honor and a responsibility to our patients... to demonstrate that we care about our profession and the quality of health care we provide. My 2 cents. Peace, Terry J. DuBose, M.S., RDMS, APS Assistant Professor & Director, Diagnostic Medical Sonography Program CHRP, University of Arkansas for Medical Sciences Little Rock, Arkansas, USA 501-686-6510 http://www.io.com/~dubose/ http://www.uams.edu/CHRP/dmshome.htm http://www.obgyn.net/us/panel/panel.htm -----Original Message----- From: Belal Hossain [mailto:bhossain@doctor.com] Sent: Wednesday, August 29, 2001 1:46 PM To: Multiple recipients of list ULTRASOUND Subject: Missing fetus Why does there are situations where triplets are missed and reported as twins?In one case a twin was reported as singleton in 2nd trimester.I suppose it's a plane problem. Dr Belal Hossain MD Modern Polyclinic and Nursing Home Kolaghat.India
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