Re: GYN:Suggestions please

From: Scotia Phillips, RT, RDMS (scotia@bellsouth.net)
Sun Aug 30 07:29:31 1998

It is interesting to me that one office where I scan has the oldest sonography equipment and the most modern table so I can trendelenberg at that place. However, where I have the best equipment also is the most primitive table!!! Go figure that one. Anyway, I have had great success in the patients with two manuvers. On one, we bring the legs up over the chest as much as possible while scanning vaginally. For the other, have the patient get on all fours on the table and scan from behind. This can also be accomplished with the patient standing beside the table and bending over, particularly in the massive obese patient.

There are a few problems with these techniques. You absolutely must have a very co=operative and understanding patient who is interested in hepling you obtain the best possible view. Many women will not want to place themselves in what some may consider a humiliating position. It is best to have help with these manuvers. Some women are willing in the spirit but unable to do this physically. I prefer to have the doctor present to view as I scan so that there is no question about obtaining correct images, This is not a procedure that you want to repeat.

If you can try these, you will be surprised at how helpful they are.

At Fri, 28 Aug 1998, yani wrote: >
>At Tue, 14 Apr 1998, J.Tomko wrote:
>>The trendelenberg position would be of tremendous help definitely. But, since you don't have access to such a table, then I would suggest applying extra pressure and angling from the side.
>>I have been seeing many more post-menopausal women lately and am
>>frustrated with scanning technique when the patient presents with
>>uterine decensus (and retroverted position.) It seems I cannot
>>adequately image the detail of the uterus and ovaries with
>>transabdominal approach and the angle is too perpendicular to the u/s
>>beam to get a true long axis and coronal view of the uterus with vaginal
>>views. I tried gently reducing the decensus with the vaginal probe but
>>cannot move the uterus high enough in the pelvis to work this out. The
>>pessary of course hinders ultrasound impossible. I do not have a table
>>to trendelenberg the patient. ~~Any~~ suggestions or technique tips are
>>welcomed.
>>
>>Thanks,
>>
>>Janet
>>
>>--
>>Does a Roman EMT call an IV a '4'?
>>

--
Scot



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