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Re: Nuchal CordFrom: Philippe Jeanty (jeanty@TheFetus.net)Sat Feb 21 18:38:58 2004
My sonographers are my eyes... no wonder I treat them with utmost respect ! -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Sue Davies Sent: Friday, February 20, 2004 9:23 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord Thanks from me too Dr Jeanty, there are many practices in Australia where sonographers are treated as medical professionals with sound judgement and the ability to talk to patients sensibly and it is nice to hear that your is one of those too. 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: Saturday, 21 February 2004 6:36 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord Dr. Jeanty. Thank you. 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 Philippe Jeanty Sent: Friday, February 20, 2004 10:03 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord Not wanting to pour oil on the fire, but I let my sonographers tell the patient about nuchal cord. There are several reasons for that: 1) my sonographers are very qualified people with excellent clinical judgment 2) when they start taking extra pictures of something, a great proportion of patients notice the "change" in the conduct of the examination (they concentrate more on something, they stop talking for a few seconds...) 3) they have heard me tell the patient thousands of time what it meant and are not likely to say something stupid 4) the patient having heard the story once is better prepared to ask me questions Further I thing it is a basic matter of human respect 1) for the patient to be informed and 2) for the sonographer to be regarded as a medical professional and not some moron button pusher Philippe Jeanty, MD PhD -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Sue Davies Sent: Thursday, February 19, 2004 4:28 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord If I could buy into this one - surely a sonographer is duty bound to examine the fetus in all its aspects and document the findings. We routinely include cord examination in third trimester scans, it is the obstetrician's duty to discuss the results with the patient and make decisions on management, if a sonographer finds a nuchal cord wrapped securely (3 or 4 times circumferentially) and does not report this, they would be liable for censure if anything went wrong. Maybe the best outcome for your current difficulty would come from the referring physicians having a discussion with the sonographer in question and make them aware of their cocerns 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 Charlotte Henningsen Sent: Friday, 20 February 2004 8:01 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Nuchal Cord
At Thu, 19 Feb 2004, Philippe Jeanty, MD, PhD wrote:
>
I agree that if we see a nuchal cord that it is our duty to document it, so
it is reported to the managing physician and the patient can be apprised.
And certainly if there is accompanying decreased movement or bradycardic
episodes. But do you routinely look for a nuchal cord? That is not part of
standard protocol, and is what this particular sonographer is doing.
Charlotte
>-----Original Message-----
>only creates angst for the patient with a situation that may be
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