Clinical rotation 1-29-2011

This week I did not scan as much as I would have wanted, and on Friday I felt aprehensive about an abdomen study, because the tech was in the room with me while I was scanning, and she kept saying" No, don't take that", but she did not tell me why or how to improve it, so I decided for the sake of time, to hand her the probe and let her finish the exam. She came to me after the exam and asked me why was I hesitant in the room. I found it hard to express my true feelings, because I did not want to start a conflict. I am sure that by now, the techs have higher expectations of me, and I cannot come across as stand-off-ish. I will try harder to be more assertive, and display more confidence.

Clinical rotation 1-21-2011

Today concludes our first week of 2 day school and 3 day clinicals schedule. It is more challenging to do both, but it makes it more interesting, because we learn about OB/Gyn in class and we get to apply it in clinicals as we go along. I took Friday off, due to flu like symptoms, and I hope to get better by next week, on Wednesday. I have enjoyed being in clinicals this past two days and I am getting to be more comfortable scanning. I have seen a lot more pathology this week, and it is helpful to correlate it to our lectures. Some examples include: large liver cysts, pleural effusion, renal tumor, etc.

January 14th 2011, after my fourth week in clinicals

Today we end another 2 week course of clinical hours. I have spent most of my time either scanning or observing the ultrasound procedures at SMIL, Mountain View office. I got a chance to work with most of the techs, and I like most of them. They are all different and I am doing my best at learning how to interact with all of them. Some of them like me to start scanning and they scan after me, and finish the exam, while others prefer to scan first and then, if time allows, I get to scan. I am not sure, yet which one of these two approaches I like best, but I am glad when I get to scan at all. Sometimes, there is a time limit, or the patient is in a hurry, so I do not have a chance to scan, but most of the time I try to fit in some scanning time.

Jan 07 2011, after my third full week in clinicals

At the end of my third full week in clinicals, I feel better about my scanning, and I am sure it will only get better. But I still struggle with the abdomen studies on larger patients, and with the fact that some of the techs are not willing to teach us. I will have to stick to the ones that are willing to show me the ropes, and guide me on this path of learning.

At the end of my second week in clinicals 12-23-2010

I spent two weeks without Kim at my clinical site and I have worked with many techs. I am ready to work with my clinical instructor, Kim, and work at perfecting my abdomen scanning routine. Many patients have gas, and it is hard to find the perfect window for the liver and great vesels. I will try to enjoy my week off, and return to the site on January 3rd, after spending some quality time with my family. Merry Christmas and Happy New Year!!!

After one full week of clinicals

I spent one full week at my clinical site. I rotated from the suite 100, to the women center and even to the vascular lab, suite 201. It has been interesting and I am ready to start scanning myself soon.

My first day of clinicals 12-13-2010

Today I started my clinical rotation. I am assigned to SMIL, Desert Mountain office, on Shea and 101. It is a long drive and I left one hour and a half prior to my starting time. I got there on time, and found where to go to sign in on the computer. I met Kim and I was introduced to all the other technologists. I spent my first day with Stephanie Flores, following the techs and observing their routines and preferences.

DMS 110 lab 12-2-10 Thyroid

After one week off ( Thanksgiving week) we returned to DMS 110 lab.
Today we scanned for the first time the thyroid, both in trans and long. I measured the gland in long. We also used for the first time the dual screen, or extended view. We used color Doppler to see the blood flow, in longitudinal view.

DMS110 lab 11-18-10

Today we practiced scanning the entire abdomen in one hour. I took images of GV, liver, GB, CBD, both kidneys, and spleen. I was not able to see the pancreas due to a large amount of gas in my patient's bowel. The focus in this lab was optimizing the images, by breathing techniques, adjusting gain, depth and focus. I also changed my pre-sets and used the auto optimize button. I liked the renal pre-set for the kidneys. Also finding different windows helped me see the left kidney and the spleen.

DMS 110 lab 11-4-2010 Spectral Doppler

Today we learned how to use spectral Doppler, combined with color Doppler. We did not change the angle of insonation, at least not on all the images. I obtained images of right kidney in long and trans with spectral arterial and venous waveforms. I found that in long I got better arterial waveform, and in trans I got better venous waveform.
We also imaged portal vein with spectral flow, and the aorta, at the celiac axis, and at the proximal and distal location. We practiced more finding the CBD, and we measured it at the pancreatic head. I liked this lab because I learned hands-on about the spectral Doppler, and I learned about how different the velocity of the blood is in different spots of the body. For example the velocity in the celiac axis was about 100cm/s, and in the portal vein was 20 cm/s. The part that I found challenging was finding the optimal angle, and position in order to obtain an accurate velocity. I am sure that this will come with more practice and knowledge of physics.