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Re: Protocols for ER PelvicsFrom: Joseph Allen Worrall Jr. (jworrall@alaska.net)Mon Aug 24 21:02:43 1998
It has been my observation that radiologists (who are physicians but probably are not comfortable doing pelvic speculum and bimanual exams on women) and the sonographers who work strictly in a radiology department, (male or female) are not comfortable doing transvaginal scans. I am sure there are radiology departments where that is not the case, and probably Donna K works in such a radiology department. I would not expect a sonographer who works or has worked in an ob/gyn practice to have that reluctance. I can understand it. If someone asked me to do a transrectal scan, I would feel awkward about it (over and above the fact that I would not know what the heck I was doing). Yet if I were a proctologist or a general surgeon, or any type of physician that regularly did colonoscopy, anoscopy, and sigmoidoscopy, I probably would not have the slightest hesitancy in putting the transducer in the rectum. But the scene that Victoria describes is really awful. I agree of course that transvaginal scanning is wonderful, and I think back to the early days of real time sonography when transvaginal scanning was not available! How much less certain we were of things then. Today I scanned a pregnant woman whose BMI (body mass index) was 59! She weighs 367.5 pounds! She is huge, and even the TVS was compromised by her obesity. She is 11w3d pregnant, and I did not bother scanning her abdominally. Later in pregnancy I will have to. To add to the problems, she has had a previous term stillbirth, pregnancy induced hypertension, and a previous C Section. I am glad I do not do OB any longer! She is a lovely woman. She has had one good pregnancy and a young son, and I hope she does as well this time. Joseph A Worrall MD RDMS
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