Maybe It's A Glitch

Echocardiography world does not have it's own URL for some reason.  I have worked for an hour for an answer.  Perhaps Larry, and Sergei can help me out.  Many people have located echocardiography world through diligent searches.  I thank you for finding me.  For now I am trying to link echocardiography world to sonoworld. Bear with me.

TJW

Embolisms And Diagnosis

One of the many issues sonographers have to deal with is the source of an embolism.  Currently, when a patient has a CVA (Stroke) or RIND (resolving intermittent neurologic defect), and echocardiogram and a carotid Doppler are ordered.  This post does not deal with these issues, rather I am posting something far more reaching.  Guidelines for ordering vascular testing.  Often times we are called up at 3am for a DVT study.  Most  people do not understand that DVT does not cause a stroke.  It may cause a pulmonary embolism.  Patients who suffer from atrial fibrillation have a high incidence of stroke.  This is why they are commonly prescribed medications that reduce the incidence of clot formation in the left atrium of the heart.  I have no issue with this therapy.  I think it is common sense.  As an echocardiographer, I must always be vigilant for masses in the heart.  But here is something I came across at Sonoworld.  Blessings to you folk's.

Applicable to patients with venous disease and severe chronic kidney disease

A new report issued today by the American College of Cardiology (ACC) and developed in collaboration with 10 other leading professional societies provides detailed criteria to help clinicians optimize the appropriate use of certain noninvasive vascular tests when caring for patients with known or suspected disorders of the venous (veins) system. Also included are first-time recommendations for when and how to use these tests to plan for or evaluate dialysis access placement.

"Vascular lab testing is central to the care of patients with most peripheral vascular disorders, but appropriate use criteria for these [technologies] have lagged behind those for cardiac testing," said Heather Gornik, MD, FACC, cardiologist and vascular medicine specialist at the Cleveland Clinic and chair of the writing committee. "With this report, we now have multidisciplinary criteria upon which we can start maximizing the quality and appropriateness of what we do in the vascular lab every day."

Vascular testing is often used to help evaluate possible venous thromboembolism, which is the third most common cardiovascular disease, after coronary disease and stroke, and includes deep vein thrombosis (DVT) as well as pulmonary embolism (PE). These conditions can be fatal and result in hospitalizations and long-term complications. Therefore, identifying the best methods for detecting clots in the veins early on can be lifesaving, Dr. Gornik said. "But we must know that we are ordering the right test for the right reasons," she added.

Here is the link  Thanks Sonoworld

http://www.eurekalert.org/pub_releases/2013-07/acoc-nrh071913.phphttp://www.eurekalert.org/pub_releases/2013-07/acoc-nrh071913.php

Just a note to friends: My son is in the air at this moment traveling to Guatemala to do some hard work for our church. My wife and I are not on the plane. This is his first real journey to see what the world is like without McDonalds, and Taco Bell, and the air conditioning we Americans have come to accept as something we are used to. He did not take his X-BOX. Our family is all about health care. All three of us have been to Guatemala on mission trips. My trip was 7 years ago to deliver an ultrasound machine and provide education to the doctor and nurse who take care of thirteen tribes of Mayan Indians who live near lake Atitlan. My wife traveled there 3 years ago to administer vaccinations as a nurse. Today mark's a family tradition. My son, Trevor will put muscle and intelligence to work to assist people to get better living conditions. I am proud of my entire family. Pray for his success, and safe return.

Blessings all.  This post is on the Sonographers blog.  wwwsonographersblog.blogspot.com  

What Is a Sonographer? (Editorial From The Heart)

A sonographer is a human.  We are not computers.  We are the people that greet you and treat you with respect.  We tell you we are going to probe your body in intimate ways.  We are some of the most intimate health care providers you will encounter in the medical world.  We look into your chest, into your arteries, and into the womb.  We are people who know you from your ass-hole to you appetite.  We love our patients.  We know when the bulge in the abdominal wall is a hernia, or a sign of cirrhosis of the liver.  We are frequently the first people to find that your foetus has a heart beat, or not living.  We are not nurses, or doctors.  We are the people that try to figure out what is wrong with your tummy at 3AM in the morning.  We are frequently questioned by doctors as to what the diagnosis is.  Many of us offer non-legal opinions.  Most of our opinions make or break a medical decision.  We sonographers are careful, and thoughtful people.  We make our decisions based upon extensive medical histories, lab results, and physical findings.  Sonographers are some of the most valuable people on the planet. Sonographers are often very well educated.  Most sonographers are certified by an agency in the USA. Many sonographers suffer constant callbacks, and scrutiny by scruffy radiologists, cardiologists, and other medical doctors who think they know how to interpret ultrasound images. Many sonographers must interpret the images for the physician because the physician lacks knowledge.  All patients ask the sonographer if there is something wrong.  We are trained to be poker-faced.  Some of us do not know how to play poker well.  We are all human.  Next time you have a sonogram, echocardiogram, carotid ultrasound, venous ultrasound remember that we sonographers are humans also.  We care about you.

Written with Respect.

TJW

Ultrasound Gel: Proper use

This is a cross post from Sonographers Blog.  The way we store and warm our ultrasound gel in the echo lab is not as critical as in the OB-GYN and abdominal lab, but I still fell like I should cross post to this forum.  Echocardiographers need to clean out the dozens of gel bottles they have on the counter or in a cabinet for a couple reasons: 1) HIPAA and JCAHO do not like to see these bottles.  2) These bottles harbor pathogens that are pretty nasty.  I do not see many infections caused by old bottles of gel in the cabinet, but you never know.  Look at the bugs in Saudi Arabia.  Who know's where they live.  Many echo labs perform post cardiac surgery echos.  Enough said.  Here is the link.  Blessings.

CHICAGO (November 12, 2012) – In the December issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, guidelines have been proposed by epidemiologists from Beaumont Health System to reduce the risk of infection from contaminated gels. The recommendations are based on the authors’ own experiences with an outbreak traced to contaminated ultrasound transmission gel.

In December 2011, researchers uncovered an unusual cluster of Pseudomonas aeruginosa in a cardiovascular surgery intensive care unit during routine infection control surveillance. The outbreak was found to have stemmed from bottles of ultrasound transmission gel that were contaminated during the manufacturing process and that were being used for intraoperative transesophageal echocardiography.  This information ultimately led to a national recall of the product.

Thanks Sonoworld and all.

http://www.shea-online.org/View/smid/428/ArticleID/182.aspxhttp://www.shea-online.org/View/smid/428/ArticleID/182.aspx