The healthcare landscape is changing in subtle and obvious ways. A subtle way is the pressure to minimize radiation doses. An obvious way is healthcare reform which is focused on delivering better patient care while lowering medical costs. Both have implications for sonography techs. Sonographer skills are critical to the delivery of efficient and accurate patient care, and ultrasound is less expensive than x-rays (Compare Ultrasound Technicians with X-Ray Technicians). A growing discussion centers on the greater reliance of physicians on critical sonographer skills.
Detecting Contrasting Cues the First Challenge
Read a list of sonographer skills in a job description, which includes things like the ability to operate ultrasound equipment and good interpersonal skills. These generalizations do not really give a true sense of the critical nature the skills the sonographer tech develops and utilizes on a daily basis.
Skilled Diagnostic Medical Sonographers do much more than “operate technical equipment” or “read ultrasound images (check types of ultrasound scans).” They are challenged with each and every exam to visually interpret images that may only provide vague contrasting clues as to the presence of an abnormality or a medical condition.
In addition, the sonographer is often challenged by the patient’s condition. For example, some patients have a mass or abnormality that appears and disappears while in motion or at rest. These are difficult to see abnormalities that are disguised or hidden by surrounding tissue. Some conditions are best recognized by obtaining a holistic view rather than a small, focused view.
The physician is depending on the sonographer to deliver the images that will enable the best diagnosis given the available information. This responsibility is often carried out under stressful conditions in which patients are ill, upset, or worried. The one thing the sonographer can count on is that the ideal situation is not likely to exist during an exam, but that is precisely why so many ultrasound professionals find the work fascinating.
Sonography Techs Learn to Capture Dynamic Clips
There are many technical skills, coupled with good judgment, that sonographers apply every day to get the best images. The physician counts on the ultrasound technician’s skills, and many of the skills are not always specifically listed in an occupational job description. For example, the ability to take dynamic clips is one.
Ultrasound dynamic clips are like a series of images taken closely together. They can detect abnormalities that regular imaging would not uncover. For example, dynamic clips are critical to diagnosing an anterior tibialis hernia which can appear and disappear.(1) The dynamic clips can be stationary or sweep. The stationary dynamic clip can image a moving structure and detect an abnormality that is elicited by the patient’s movement. A sweep dynamic clip images a 3-dimensional structure and can detect subtle echotexture abnormalities.
A sonographer who has experience with the dynamic clips is more skilled than sonographers who are mostly familiar with static images and is likely to earn a higher sonography tech salary. Technique is critical to success in taking dynamic clips. For example, the sweep clip has to be completed with a steady, even speed. When completed with skill, the dynamic clips can greatly improve diagnostic accuracy. Dynamic clips are valuable diagnostic tools when:(2)
- Patient structures are easier to see when the patient is in motion
- Including surrounding structures helps pinpoint the abnormal tissue
- The extent of an abnormality in an organ or tissue needs assessing
- More accurate assessment of venous walls is needed
- A holistic view of a structure is needed
- The patient is unable to control movements due to disease or severe pain
One of the reasons dynamic clips have not been used more regularly is that software needed to be developed to integrate the dynamic clips with the picture archiving and communication system (PACS) so that manual intervention is not necessary. That has been accomplished, so expect to see growing use of dynamic clips.
Preparing for the Future
A top attraction of a sonography tech career for many people is the fact that technology is ever-changing. This challenges ultrasound professionals to stay on top of current developments and to continually develop high-level skills after completing a sonography program at one of the ultrasound technician schools. One thing is for certain: technology will always continue to advance.
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(1) Suheil Artul and George Habib, “The importance of dynamic ultrasound in the diagnosis of tibialis anterior muscle herniation,” Critical Ultrasound Journal, 2014, 6:14, doi:10.1186/s13089-014-0014-0.
(2) Dr. Roy Filly, “Ultrasound exams present interpretation challenges,” AuntMinnie.com, (March 20, 2015).