Ultrasound Education (Editorial)

The state of ultrasound education is pitiful.  I am an educator, and I have a right to whine because offices and hospitals are buying ultrasound machines, but not sending the health care professionals who operate the equipment to school to learn how to operate the machines.  We teachers need to make a living also!  Enough of that stuff.  I can pay the mortgage by seeing patients but my point is made.  Buy an ultrasound machine then pretend you know what you are looking at through all the gel?  Ultrasound manufacturers are recording great sales.  Many doctors offices are buying them and telling an employee to "see what you can see with the machine", and billing for it.  No wonder health care insurance premiums are going up like a volcano!  It does not help that this current administration is promoting WELFARE healthcare.  I am a registered sonographer, and I am worried that if we are cutting corners here, where else are we cutting corners in quality health care?  One day I will be old and in the hands of a health care professional.  I intend to ask that person of he or she is licensed or registered in that aspect of health care.

Anyone in the USA can purchase a gun in the USA unless they are a felon.  When you buy a gun do you automatically know how to use it responsibly?  NO.  You must take a gun safety course to learn to use it for hunting or self defense.  The same is true for an ultrasound machine.  You get a day of apps from the manufacturer, then you are on your own.  Apps specialists do not train you how to do a sonogram, they show you how to operate the equipment.  To learn how to use an ultrasound machine requires rigorous education and training accompanied by many patient encounters.  Too many physicians and imaging facilities think the ultrasound machine is like an EKG machine: put the electrodes on the chest and let the machine do the work.  I want you all to embrace ultrasound as a valid and useful tool in diagnostic medicine, but get some training on how to use the equipment!  Just my thoughts.  Have a great holiday weekend.

Ultrasound Breaks Bubbles Releasing Clot Busting Medication

In another novel study, ultrasound has been proven to release clot busting agents in blood clots potentially reducing or eliminating the effects of the clots on the brain, or other organs.  This is great news for people who suffer from strokes caused by blood clots to the brain.  We have known for years that medications can be encapsulated in lipids and released when irradiated by ultrasound.  This article takes it a step further.

CINCINNATI—A new study from the University of Cincinnati (UC) College of Medicine has found that, when delivered via ultrasound, the natural enzyme plasmin is more effective at dissolving stroke-causing clots than the standard of care, recombinant tissue plasminogen activator (rt-PA).

The novel delivery method involved trapping plasmin into bubble-like liposomes, delivering them to the clot intravenously and bursting it via ultrasound. That method is necessary, says UC associate professor of emergency medicine George "Chip” Shaw III, MD, PhD, because plasmin cannot be delivered through traditional methods. Intravenous delivery of rt-PA is designed to solve that problem by catalyzing the conversion of existing plasminogen inside the body to plasmin, which in turn degrades blood clots.

"Plasmin is the enzyme that actually chews up the fibrin in clots,” says Shaw. "The problem is you can only give plasmin inter-arterially, which has safety risks and takes longer to deliver. IV therapy is always easier and quicker, but if you give plasmin intravenously, the body inhibits it immediately. If you can encapsulate it, it doesn’t get inhibited and you can target it to the clot.”

Thanks UC and Sonoworld

http://healthnews.uc.edu/news/?/22587http://healthnews.uc.edu/news/?/22587

Fast Scan Gets a Boost With New Software

Nice stuff coming from the computer generation.  Now they have a graphics program to guide the health care provider on how to perform a FAST exam.  I think it is great for the bloody savage generations the liberal media think we should all worry about. The software and hardware machine guides the health care provider to do an assessment of a person abdomen in the case of trauma looking for free fluid using a graphical guide as to where the probe should be pointed.  I would agree this is great, but in the hands of a person who is not trained in ultrasound it could cost money and lives. Take for instance the person with chronic ascites. Ascites is a build up of abdominal fluid which is linked to any kind of liver disease.  I still think people need education when they use any kind of ultrasound machine.  You make the call my friends.  Here is the link.  Nasty font  but here it is:

Under this project an advanced software system will be developed to improve detection of life-threatening internal bleeding after blunt abdominal trauma.

Clifton Park, NY (PRWEB) May 09, 2013

Kitware, a leading-edge medical imaging software provider, today announces new Phase I SBIR funding from the National Institutes of Health for the development of hardware and image analysis algorithms that will allow novice ultrasound operators to perform life-saving Focused Assessment with Sonography for Trauma (FAST) procedures.

FAST procedures are rapid ultrasound examinations for identifying abdominal hemorrhaging, which is often associated with blunt abdominal trauma (BAT). Detection of this free fluid is done via ultrasound images of four specific abdominal areas. Patients with positive FAST results are in urgent need of treatment, whereas negative results indicate more stable patients.

Read more: http://www.virtual-strategy.com/2013/05/09/kitware-improve-focused-assessment-sonography-trauma-fast-procedures#ixzz2TDh6N1vT
Read more at http://www.virtual-strategy.com/2013/05/09/kitware-improve-focused-assessment-sonography-trauma-fast-procedures#Ku02LvF8914SJbf1.99 

Obesity and Pregnancy

Nothing against obesity here.  I make my living from treating barometrically challenged people.  This is not a hate post, so do not start on me.  The point I want to make is that obese mothers-to-be have more than gestational diabetes to worry about.  We all know that heavy people have issues in the social and medical stage.  I think this link may be informative at the least, and alert people what sonographers face daily.  Doing a sonogram on an obese person is physically, and mentally challenging.  Most sonographers hate to do bad work.  We hate it when we cannot see the baby and turn in pictures that are less than diagnostic. This also applies to all other ultrasound examinations including vascular, echocardiography and abdominal exams.

Pregnant women who are morbidly obese may need more time during theirultrasound appointments and more frequent visits because their babies may be difficult to image, researchers report.

"There's a real prevalence of obesity in women of reproductive age; nearly one third of women are obese." In addition, nearly 8% of these women are morbidly obese, with a body mass index of more than 40 kg/m², said Robert Ehsanipoor, MD, from the Johns Hopkins University School of Medicine in Baltimore, Maryland.

Thanks Sonoworld

http://www.medicexchange.com/news-article/overweight-pregnant-women-need-more-ultrasounds.html

NASA Hall Of Fame in Ultrasound

As many of you know I am a big supporter of NASA, and work with them as an outside contractor here in Houston.  Software developed by a couple buddies at Johnson Space Center, and Henry Ford are key to training these fine people who risk their lives in space up to 6 months at a time.  Please see the below article I posted two weeks ago about Henry Ford.  There is a wonderful program I was gifted with courtesy of Johnson Space Center and Henry Ford that I use to instruct my sonography students.  It allows me to become very simple in terms of ultrasound imaging.  I will post the link soon, as I do not have it on this computer.  I would like to thank the people at Henry Ford Hospital, in Detroit, and people at Johnson Space center before I post a link.  This special software is great in it's simplicity and wonderful educational abilities. Consider this  an editorial.  Sorry I hate to bait you folk's.  But I must ask Permissions.  Scott, if you read my Blog please send me a message.  Same to you Kat.  This blog has a small following.  I want to keep it growing  I will try to play it by the book.  NASA plays it all by the book.

Be at peace all.

News  I started a new blog called echocardiographyworld.blogspot.com
 Lemme make the first post

Endothelial Dysfunction: A New Test

I have a brief article regarding a test that is non-invasive and which can predict a persons cardiovascular health. the Endopat test uses a pressure cuff and expensive finger sensors to evaluate a persons vascular resistance.  Vascular resistance refers to the force needed to perfuse the arteries in the body by the heart.  It concludes that the higher the resistance, the stiffer the blood vessels, thus the more disease prone they are.  I have learned to perform this test, and will soon be testing patients in the clinic.  I think it has merit in that it is FDA approved and backed by some solid research.  I am not sure that I want to be told I may have a heart attack within 7 years though.  I took the test myself, and scored very well.  I guess that is good news.

LOS ANGELES (CBSLA.com) — The number one killer in America is heart disease.

Now there’s a simple new test that possibly predicts heart disease years in advance not by looking at your heart, but your fingers instead.

KCAL9′s Juan Fernandez spoke to Dr. Chris Renna of LifeSpan Medicine in Santa Monica to find out how the test works.

“Endothelial function is the bomb. That’s the money,” he said.

Blood vessel health can be easily checked with the EndoPat test, according to Dr. Renna.

 Here is the link.

http://losangeles.cbslocal.com/2013/05/03/medical-test-uses-fingers-to-predict-heart-disease/

Thanks Drudge and CBS LA