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Re: Nuchal CordFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Fri Feb 20 07:05:58 2004
Sue, what you say is true. However, it still does not answer the question of what a sonographer should do when they observe a nuchal cord, which is just across the fetal shoulder and not wrapped tightly around the neck or 2-3 loops around the neck. As I understood the original question, the physician did not think it was important and did not want the sonographer to draw attention to the nuchal cord (comment or record images) because the physician then felt obligated to comment in the report. I have worked with physicians who also did not want incidental findings recorded because they then felt obligated to comment. So the question remains, should the sonographer ignore conditions which they believe are insignificant or not, or should they give all information to the physician and let her/him make the decision? Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM Assistant Professor & Director Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot #563 Little Rock, Arkansas, 72205 USA 501-686-6510 DuBoseTerryJ@UAMS.edu http://www.io.com/~dubose/ http://www.uams.edu/chrp/dms/default.asp http://www.obgyn.net/us/panel/panel.htm ---------------------------------------------------------------
--------------------------------------------------------------- -----Original Message----- --------------------------------------------------------------- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Sue Davies Sent: Thursday, February 19, 2004 8:07 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord I agree Terry, that is why referring physicians should discuss such things with both the radiologists and the sonographers in their area so that all are aware of what is considered best for their particular needs. Cheers Sue Davies Program Director PO Box 434 Mermaid Beach, Q, 4218 tel: (07) 5526-6655 http://www.aiu.edu.au -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of DuBose, Terry Sent: Friday, 20 February 2004 10:44 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord As I understood the original question, it was not the sonographer telling the patient about the cord, but the physician did not want to know if the cord was just draped over the fetal shoulder, with a film showing this, because the physician then felt obligated to comment in the report about in case there was a poor outcome. So should the sonographer take a picture of a nuchal cord that does not encircle the neck two or more times? Or ignore it... that is the question, as I understand it. Sonographers are expected to take diagnostic images, but not considered a diagnostician, even though their credential is "Registered Diagnostic Medical Sonographer". They are between a rock and a hard place with many physicians. Peace, Terry J. DuBose, M.S. RDMS Little Rock, Arkansas ------------------------------------ I absolutely agree......why is a sonographer telling the patient ------------------------------------ about -- ------------------------------------ the cord? Perhaps a policy should be put in place that the sonographer tells the doc about the cord, then leaves it up to the doc to tell the pt.
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