LLUMC Ultrasound

Protocol Manual

Table of Contents

Department Procedures

• Staff Schedules & API
• After Hours Protocol
• After Hours Exams
  • STAT Obstetrical US Orders
  • STAT Vascular Orders
• Triaging Exams
• Call Coverage and Back-Up Procedure
• Shift Coordinator Responsibilities
• Weekend Workflow for All Staff
• Transvaginal US Exams for Patients on Telemetry
• Medical Center Procedures
  • Breast Needle Localizations
  • MSK Injections
  • Renal Biopsies
• How to Complete LLEAP Time-Out
  • Time-Out
• How to Add-on STAT Patients
• How to Transport Patient to the Medical Center
• Exam Room Preparation
• Exam Table Weight Capacity
• Ultrasound Gel
• Radiology Protocol for Correct Patient Imaging
• Processing Each Patient
• Technical Suggestions
• Trophon ® HLD
• Ergonomics
• Documenting Fall or Injury to Inpatient or Outpatient
• Documenting Fall or Injury to a Visitor
• How To Call A Code
• Comprehensive Stroke Center
• Stroke Recognition
• Stroke Activation
• Stroke Time Target: Ischemic Stroke

Abdominal

• Abdomen
  • Liver Anatomy & Couinaud’s Nomenclature
• Abdomen with Doppler
• Abdomen for TIPS (Trans-Jugular Intrahepatic Portosystemic Shunt)
• Abdomen for Ascites or Abscess
• Abdominal Soft Tissue
  • For Superficial Masses, Abscess, or Hematoma
  • For Urachal Anomalies
• Abdominal Wall Hernias
  • Ventral Hernia
  • Groin Hernia
• Aorta
• Aortic Endografts
• IVC
• Mesenteric Doppler
• Mesenteric Endografts
• Renal
• Renal Artery Stenosis
• Renal Vein Thrombosis

Chest

• Pleural Effusion
• Diaphragmatic Motion

Gastrointestinal

• Gut Signature Anatomy
• Appendix

Localization

• Localization for Ascites
• Localization for Liver Biopsy
• Localization for Pleural Effusion

Male Exams

• Male Breast
• Penile
• Prostate
• Scrotal

Musculoskeletal

• Hips for Effusion
• MSK Invasive Procedures
  • Steroid Injections
  • Iliopsoas Injection
  • Adductor Muscular Injection
  • Greater Trochanteric Bursal/Gluteal Injection
  • Subcoracoid Injection
  • Biceps Tendon Injection
  • Aspirations of Fluid Collections or Joints
  • Resident Responsibility
  • Technologist Assistance

Pelvis

• Pelvic
• 3D Pelvic Floor Evaluation
• OB < 14 Weeks: Endovaginal and/or Transabdominal

Small Parts

• Breast
  • Male Breast
  • ED/STAT Breast Ultrasound for Abscess and Screening Pre-Transplant Inpatients
  • Ultrasound Grading of Breast Lesions
  • Breast Biopsy
  • Breast Cyst Aspiration.
  • Breast Needle Localization
  • Breast Specimen
  • MAG View
• Extremity Soft Tissue
• Neck Soft Tissue
• Parathyroid
• Thyroid
• Post-Operative Thyroidectomy

Transplants

• Renal Transplant
• Liver Transplant
• Pancreatic Transplant

Vascular

• Types of Vascular Exams

Vascular Venous

• Upper Extremity Venous (UEV)
• Lower Extremity Venous (LEV)
• Venous Reflux
• GSV Closure
  • Intra-op GSV Closure
  • Post-op GSV Closure
• Vein Mapping
  • For Surgical AVF Creation in the Upper Extremity
  • For Endo AVF Creation in the Upper Extremity
  • For Bypass Graft: LEA or CABG
  • For Central Venous Line Placement (CVL)
  • Femoral Vein Mapping for Hemodialysis in the Lower Extremity

Vascular Arterial

• Upper Extremity Arterial Duplex, STAT
• Lower Extremity Arterial Duplex, STAT
• Extremity Duplex Arterial Waveforms
• Femoral-Popliteal Aneurysm
• Iliac Arterial Exam
• Hemodialysis Doppler Evaluation for Surgical AVF
  • Dialysis Catheter Diagnosis Criteria
• Distal Revascularization with Interval Ligation (DRIL) Bypass
• Hemodialysis Doppler Evaluation for Endo AVF
• Pseudoaneurysm & AVF
• Internal Mammary & Epigastric Artery
• Transcranial Doppler (TCD)

Appendix

• OSC HITACHI Quick Reference Guide for Venous Ablation
• California Code of Regulations