Diagnostic imaging embraces several procedures that aid in diagnosing ailments. The most familiar procedures are the x ray and the magnetic resonance imaging; however, not all imaging technologies use ionizing radiation or radio waves. Sonography, or ultrasonography, is the use of sound waves to generate an image for the assessment and diagnosis of various medical conditions. Sonography commonly is associated with obstetrics and the use of ultrasound imaging during pregnancy, but this technology has many other applications in the diagnosis and treatment of medical conditions throughout the body.
Diagnostic medical sonographers use special equipment to direct nonionizing, high frequency sound waves into areas of the patient's body. Sonographers operate the equipment, which collects reflected echoes and forms an image that may be videotaped, transmitted, or photographed for interpretation and diagnosis by a physician.
Sonographers begin by explaining the procedure to the patient and recording any medical history that may be relevant to the condition being viewed. They then select appropriate equipment settings and direct the patient to move into positions that will provide the best view. To perform the exam, sonographers use a transducer, which transmits sound waves in a cone- or rectangle-shaped beam. Although techniques vary with the area being examined, sonographers usually spread a special gel on the skin to aid the transmission of sound waves.
Viewing the screen during the scan, sonographers look for subtle visual cues that contrast healthy areas with unhealthy ones. They decide whether the images are satisfactory for diagnostic purposes and select which ones to store and show to the physician. Sonographers take measurements, calculate values, and analyze the results in preliminary findings for the physicians.
In addition to working directly with patients, diagnostic medical sonographers keep patient records and adjust and maintain equipment. They also may prepare work schedules, evaluate equipment purchases, or manage a sonography or diagnostic imaging department.
Diagnostic medical sonographers may specialize in obstetric and gynecologic sonography (the female reproductive system), abdominal sonography (the liver, kidneys, gallbladder, spleen, and pancreas), neurosonography (the brain), or breast sonography. In addition, sonographers may specialize in vascular sonography or cardiac sonography.
Obstetric and gynecologic sonographers specialize in the imaging of the female reproductive system. Included in the discipline is one of the more well-known uses of sonography: examining the fetus of a pregnant woman to track the baby's growth and health.
Abdominal sonographers inspect a patient's abdominal cavity to help diagnose and treat conditions primarily involving the gallbladder, bile ducts, kidneys, liver, pancreas, spleen, and male reproductive system. Abdominal sonographers also are able to scan parts of the chest, although studies of the heart using sonography usually are done by echocardiographers.
Neurosonographers focus on the nervous system, including the brain. In neonatal care, neurosonographers study and diagnose neurological and nervous system disorders in premature infants. They also may scan blood vessels to check for abnormalities indicating a stroke in infants diagnosed with sickle-cell anemia. Like other sonographers, neurosonographers operate transducers to perform the sonogram, but use frequencies and beam shapes different from those used by obstetric and abdominal sonographers.
Breast sonographers use sonography to study diseases of the breasts. Sonography aids mammography in the detection of breast cancer. Breast sonography can also track tumors, blood supply conditions, and assist in the accurate biopsy of breast tissue. Breast sonographers use high-frequency transducers, made exclusively to study breast tissue.
Work environment. Sonographers typically work in health care facilities that are clean. They usually work at diagnostic imaging machines in darkened rooms, but also may perform procedures at patients' bedsides. Sonographers may be on their feet for long periods of time and may have to lift or turn disabled patients. In addition, the nature of their work can put sonographers at an increased risk for musculoskeletal disorders such as carpel tunnel syndrome, neck and back strain, and eye strain: however, greater use of ergonomic equipment and an increasing awareness will continue to minimize such risks
Some sonographers work as contract employees and may travel to several health care facilities in an area. Similarly, some sonographers work with mobile imaging service providers and travel to patients and use mobile diagnostic imaging equipment to provide service in areas that otherwise do not have the access to such services.
Most full-time sonographers work about 40 hours a week. Hospital-based sonographers may have evening and weekend hours and times when they are on call and must be ready to report to work on short notice.
| 1. | Decide which images to include, looking for differences between healthy and pathological areas. |
| 2. | Observe screen during scan to ensure that image produced is satisfactory for diagnostic purposes, making adjustments to equipment as required. |
| 3. | Observe and care for patients throughout examinations to ensure their safety and comfort. |
| 4. | Provide sonogram and oral or written summary of technical findings to physician for use in medical diagnosis. |
| 5. | Operate ultrasound equipment to produce and record images of the motion, shape and composition of blood, organs, tissues and bodily masses such as fluid accumulations. |
| 6. | Select appropriate equipment settings and adjust patient positions to obtain the best sites and angles. |
| 7. | Determine whether scope of exam should be extended, based on findings. |
| 8. | Process and code film from procedures and complete appropriate documentation. |
| 9. | Obtain and record accurate patient history, including prior test results and information from physical examinations. |
| 10. | Prepare patient for exam by explaining procedure, transferring them to ultrasound table, scrubbing skin and applying gel, and positioning them properly. |
| 11. | Record and store suitable images, using camera unit connected to the ultrasound equipment. |
| 12. | Coordinate work with physicians and other health care team members, including providing assistance during invasive procedures. |
| 13. | Maintain records that include patient information, sonographs and interpretations, files of correspondence, publications and regulations, or quality assurance records such as pathology, biopsy, or post-operative reports. |
| 14. | Perform legal and ethical duties including preparing safety and accident reports, obtaining written consent from patient to perform invasive procedures, and reporting symptoms of abuse and neglect. |
| 15. | Supervise and train students and other medical sonographers. |
| 16. | Maintain stock and supplies, preparing supplies for special examinations and ordering supplies when necessary. |
| 17. | Clean, check and maintain sonographic equipment, submitting maintenance requests or performing minor repairs as necessary. |
| 18. | Perform clerical duties such as scheduling exams and special procedures, keeping records and archiving computerized images. |
| 19. | Perform medical procedures such as administering oxygen, inserting and removing airways, taking vital signs, and giving emergency treatment, such as first aid or cardiopulmonary resuscitation (CPR). |
| 20. | Load and unload film cassettes used to record images from procedures. |
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