Chapter 2 Flashcards
What is access procedures?
Sonographic guidance for fluid, collections, masses, organs
Real time imaging throughout exam
Allows accurate needle and catheter placement
Indications for ultrasound
Diagnostic tool confirming pathology
Non-surgical interventions
Fluid aspiration
Contraindications for ultrasound
Uncorrectable coagulopathy
Unsafe route
Uncooperative patient
What is the Prothrombin Time (PT) target value
1.5-2.0
Activated Partial Thromboplastin Time (aPTT) paramaters
1.5-2.5 times baseline value
Platelet Count Parameters
50,000-100,000 per microliter
Fibrinogen Levels parameter
150-200 (mg/dL)
What vascular access can be used with ultrasound
Peripheral IV
Central Lines
Arterial Access
Where should the needle be with your transducer?
Same plane as the transducer
What is in plane or long axis view
Needle appears as hyper-echoic line
What is out of plane or short axis
Needle appears as hyper-echoic dot
Difference between Arteries and Veins in Ultrasound
-Arteries have a thicker, more hyperechoic walls
-Veins are more easily compressed than arteries
-Arteries are a high wave form
What is static guidance
Ultrasound to locate and evaluate structure
What is dynamic guidance
Utilized throughout the duration of the procedure with real time guidance
How to keep sterility with sonography guidance
-Access site should be cleaned and sterilized prior to exam
-Sterile procedures using ultrasound will require another person to run the machine
-Ultrasound transducer must also be kept sterile using a dynamic procedure (Probe cover)
What do you need for a percutaneous Nephrosotomy Tube Placement
-Local anesthetic
-22-18 g needle
-Guide wire 0.018 or 0.035 in
-Pigtail Drain 8F
-Sedation medications
-Sterile probe cover
-Sterile Gel
Paracentesis procedure indictions
-Remove ascites from the abdomen
-Diagnostic and therapeutic purposes
-Clinical indications (cirrhosis)
What is a Endovaginal Procedure Saline Infused Sonohysterography (SIS
Used to evaluate the uterine cavity and endometrium
Indications of Saline Infused Sonohysterography:
-Fertility concerns
-Endometrial polyps
-Post menopausal bleeding
-Submucosal fibroids
-Retained products of conception
Contraindications of Saline infused Sonohysteropgraphy:
-Pregnancy
-IUD placement
When should you do the Saline infused Sonohysteropgraphy
-Should be done around day 4-7 of menstrual cycle
-Endovaginal ultrasound be done prior
-Lithotomy position for patient
Steps of Saline Infused Sonohysteropgraphy
-Speculum is used to locate cervix
-It is then cleaned with iodine
-Catheter is introduced and balloon inflated when beyond cervix
-Speculum is removed and endovaginal probe is inserted
-Sterile saline is injected through catheter while scanning uterine wall
-Balloon is deflated and catheter is removed
What drainage procedures are done with ultrasound?
-Percutaneous drainage of fluid collection
-Percutaneous nephrostomy tube
-Paracentesis
-Thoracentesis
