September 1999


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"O'Brien, Carmen" <[log in to unmask]>
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UVM Flownet <[log in to unmask]>
Wed, 29 Sep 1999 11:11:55 -0700
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What an interesting response to a very timely question since I have recently
experienced this very event.  I realize that no two situations are exactly
the same and the expertise/knowledge base varies from Gen/Echo/Vascular
dependant upon the setting in which the tech practices. Some Radiologists
are open and really try to understand flow dynamics, where others don't have
a clue about doppler or the physiology of the vascular systems.  In the
second scenario the combination of Vascular is a disaster for the patients.
In some Ultrasound/Radiology departments there is no Q.A. for assessment of
accuracy, where most Vascular Labs have always done Q.A. and our mind set is
totally different because of it. In the situation where I am currently...the
entire Imaging department has had NO Q.A. ever except to track linen or
supply ordering, where the Vascular Lab has always had a Q.A. program and we
have excellent numbers and the whole community feels very comfortable with
our results.  We have picked up errors that the Radiologist have made (ECA
vs ICA) and slowly over the last few years they request that we be present
for all arteriograms on patients that we have scanned prior.  It has brought
a heightened awareness to them regarding errors and Q.A.

If techs have performed in a role where they do the "wet read" and read and
study constantly to improve the list of possible R/O's for each and every
type of exam that they do, they are very difficult to compare to a tech that
always has the exam read by a physician...Radiologist or Vascular
surgeon.....in Radiology or separate.

My personal experience in the past 3 months that I have been folded into
Ultrasound is that it sucks....the mediocrity is unacceptable to me....I
have a very difficult time with doing the ordered exam without a clue why I
am doing it, and no concept of what the ordering physician wants to know at
the end of the exam.  The physicians expect the Vascular techs to do the
appropriate exam...not necessarily the ordered exam....to answer the
question(i.e.: what is wrong with their legs?) and if they ordered Venous
but there is an arterial occlusion, we do the right exam.  So I really think
that the bottom line is the environmental expectations in which you work...