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Contents
INTRODUCTION ........................................................................................................................................ 2
ULTRASOUND ........................................................................................................................................... 3
Development in the field of Ultrasound ................................................................................................... 4
How does ultrasound scan work? ............................................................................................................. 5
Types of ultrasound scans or medical sonography used in: ..................................................................... 5
Types of Ultrasound devices or transducer: ............................................................................................. 7
Uses of Ultrasound in medical treatments: .............................................................................................. 9
How ultrasound scans can be used? ....................................................................................................... 11
SAFETY CONCERNS REGARDING ULTRASOUND ........................................................................... 12
Safety during ultrasound scan process ................................................................................................... 12
Safety on the basis of types of Ultrasound scans: .................................................................................. 13
Biological effects of ultrasound .............................................................................................................. 13
Effects of Ultrasound on the Human being ............................................................................................ 14
Guidelines for the safety of ultrasound process ..................................................................................... 16
CONCLUSION ........................................................................................................................................... 17
REFERENCES ........................................................................................................................................... 17
INTRODUCTION
I have prepared this report on the Ultrasound scan. It is very beneficial for the doctors to
understand the exact problem of the patients. These scan are so common in today’s time.
Everybody must have gone through these scans at some point in life. Some people have
misconceptions about the safety of the ultrasound procedures. Hence, in this report the safety
measures, concerns, scan processes and its uses in different treatments etc. will be discussed.
ULTRASOUND
It is a device which is used to take the image of internal parts of human body like stomach, liver,
heart etc. It uses high frequency waves to capture the image. As ultrasound device uses sound
waves, hence it is safe to use. If radiations were used in the device, then it could have been
dangerous for the human bodies. Ultrasound scan is also known as sonogram or ultra
sonography.
Sonograpghy is a general procedure of checking the status of a fetus in womb.
These scans are very helpful for the surgeons as it detects the internal problem of a body, which
a person cannot understand easily. These scans easily find out the problems in liver, kidneys,
heart or stomach (Machi, Staren, 2005).
Source: http://www.jeffersonparkvet.com/Images/UltrasoundImage.png
In physics “Ultrasound” is known as the sound which a human cannot hear as it has different
frequency. In sonography, the frequency is generally between 2 &18 MHz’s. Two types of
frequencies can be used in ultrasound scan and both have some pros and cons. The first one is
higher frequency: It gives qualitative images but do not capture the deeper images of internal
body whereas the lower frequency can capture the deeper images but its image quality is very
low.
As per the MediLexicon's medical dictionary:
"The ultrasound scan is used to capture images for medical diagnostic purposes, using the
frequencies from 1.6 to 10 MHz’s".
Ultrasound scans and sonograms: These two terms are quiet similar but has a slight difference
which says that:

An ultrasound scan is the process, the event; but

A sonogram is the image which is produced when an ultrasound scan is performed on a
human body.
Development in the field of Ultrasound
Ultrasound was first developed during the WW II to find out the submarines of enemies and was
mostly used in steel industry. In 1955, a surgeon named Donald started experimenting on a
machine to remove abdominal tumors from his patients. He discovered the different frequencies
or echo being produced from the tissues, leading him to discover Ultrasound scan to analyze and
study the mysterious world of the growing baby in a womb.
This technology spread vastly in clinical usage. In 1963, the machines were available for the
commercial purposes. And by the end of 1970’s, ultrasound became a regular part of all the
clinical processes. Ultrasound is considered as a safe procedure and mostly 99% of pregnant
women go for the ultrasound scan (Eklöf, Lindström, Persso, 2012).
How does ultrasound scan work?
It travels through the soft fluids and tissues in the body, but if something dense comes in its way,
it bounces back or echo which indicates the problematic area. For example- if scan is being done
on heart, then it will travel smoothly on the blood, but it will bounce back if touches the heart
valves.
Gallstones can easily be found out through ultrasound as if there are no stones in the kidney or
gallbladder, the ultrasound will go smoothly but if there will be stones then it will bounce back.
Bouncing effect of ultrasound depends upon the density of the object. If the density of the object
is very high then it will bounce back at much faster speed.
This bounce or echo gives the image to the ultrasound scan. The different shades of gray reflect
different problems and densities (Stadtmauer, Tur-Kaspa, 2013).
Types of ultrasound scans or medical sonography used
in:
Anesthesiology: Is used by anesthetics as a guiding tool for injecting needles near or in the
nerves.
Cardiology: It is also known as cardiac ultrasound. It uses waves or Doppler ultrasound to know
the speed of blood flow and cardiac tissue in the body. It produces three dimensional images of
the heart. It makes it easy for doctors to find out the state of heart, valves, blood flow and
problems or abnormal functions, if any, of the right and left side of the heart. Arterial
sonography can be used to find out the blockage of arteries (Carlo Di Mario, Dangas, Barlis,
2011).
Emergency medicine: When ultrasound is used in the emergency situation to assess the level of
trauma, blood flow, or to conduct the pericardial tamponade etc. of the patient.
Gastroenterology: Ultrasound scans are mainly used for detecting the problems of particular
part of the body like kidney, liver, and pancreas located in the abdomen. It can also find out the
excess of fat or gas in the abdomen.
Newborn infants (neonatology): Scan is performed to find out the health and status of newborn
baby. It is specifically done to detect the problem or injury of the brain (Haller, 1998).
Neurology: Scan is done to measure the blood flow in the veins of the body. It can detect blood
clot or blockage in arteries or veins.
Obstetric sonography: It is commonly known as ultrasound. It is the most commonly used scan
as it is used to capture the image of the fetus in the womb. It assesses the health status of the
growing fetus and mother and also assesses the progress of the pregnancy.
Source: http://cdn1.medicalnewstoday.com/content/images/articles/245491-fetus-ultrasound.jpg
This image shows the features of growing fetus inside the womb.
Left side photo: ultrasound image of a fetus of 22 weeks.
Right side photo: growing feet of the baby in the uterus during 18th Weeks.
The Ultrasound device or transducer is basically placed on the mother's abdomen. A Doppler
Sonography shows the fetus' heartbeat, and helps the doctor to detect any sign of abnormality in
the heart and blood vessels of the growing fetus (Bhargava, 2002).
Urology: Is used to find out the quantity of urine in the patient’s bladder. It detects the problem
around the area of pelvic including bladder, uterus or testicals. This is done internally or
externally. It can also be used to break the kidney stone.
Musculoskeletal sonography: To test the status of bone surface, nerves, muscles etc.
Types of Ultrasound devices or transducer:
Generally the Ultrasound device is placed on the outer part of the body, but in some cases the
devices are put internally to capture the clear image.
These are of three types of transducers:
1. Endovaginal: In women, the transducer is entered in the body through the vagina.
Source:
http://www.mayoclinic.org/~/media/kcms/gbs/patient%20consumer/images/2013/08/26/10/42/ds
00423_im04152_mcdc7_transvaginalultrasoundthu_jpg.ashx
2. Endorectal: Is used in men, the device is entered through the rectum.
Source: https://kylemtolbert6.files.wordpress.com/2013/04/mcdc7_rectum.jpg
3. Transesophageal: This transducer is entered in the body through the esophagus or throat of
the patient (Togawa, Tamura, Oberg, 1997).
Source: http://www.hopkinsmedicine.org/healthlibrary/GetImage.aspx?ImageId=322617
Uses of Ultrasound in medical treatments:
1. Ultrasound is used for therapy by providing heat to the problematic area. For therapy, the
required temperature is higher than the temperature used in normal ultrasounds. Frequency of
heat depends upon the ailment and its seriousness.
2. Dentist also uses it for cleaning the teeth.
Source:
http://1.bp.blogspot.com/-6c0F9zbYMJY/T4RKhYWgWaI/AAAAAAAAOfs/y-
M4RJnB-Qs/s400/neu_banner1_1_2.jpg
3. It is also being used in the treatment of cancer and physical therapies.
4. High intensity ultrasound is used for treating tumors and cysts.
5. To break the kidney stones, Lithotripsy is used.
Source:
http://thumbs.dreamstime.com/z/lithotripsy-extracorporeal-shock-wave-eswl-kidney-
stones-shock-waves-to-break-kidney-stone-small-pieces-can-more-48994059.jpg
6. It also stimulates bone growth.
7. It is used in patients who are in coma, or brain done not function properly, to pass the drugs in
the whole body.
8. With the help of phacoemulsification, Cataracts can be treated (Frontera, 2007).
- Phacoemulsification of Cataracts
Source:
https://www.google.co.in/search?q=phacoemulsification+of+cataract&safe=active&biw=1366&
bih=643&source=lnms&tbm=isch&sa=X&ved=0CAYQ_AUoAWoVChMI46yo4P3yxgIVixyU
Ch2DpQOR#imgrc=MpojO2nmuOjBrM%3A
How ultrasound scans can be used?
Source: http://gnmi.ca/wp-content/uploads/2013/08/Ultrasound1.jpg
Ultrasound is generally used for medical purposes. Doctors can use sonography or ultrasound for
diagnosis or treatment purpose, and as a guiding tool while carrying out any procedures, such as
biopsies.
People who perform these scans for medical usage are known as sonographer. He/she performs
the scan by placing a device known as transducer on the skin of the patient. The images of
ultrasounds are interpreted by the doctors, surgeons or cardiologist. Sonographer does not study
the scanned images.
SAFETY CONCERNS REGARDING ULTRASOUND
Ultrasound scan are considered safe for everyone. It is a complete safe and secure procedure.
Ultrasound sends sound waves inside the body of human, which bounce back if touches dense
object. These waves are converted into images which reflect the actual position or status of
internal body parts.
During an ultrasound scan, the device produces a small amount of heat, below 1 degree C, which
is easily absorbed by the body part. More than 4 degree C temperature could harm the fetus, it’s
a rare case, and otherwise the process is safe.
Now days, ultrasound machines can take 2D and 3D images of the internal diagnosed organ (Dr.
Buckley, 2005)
Ultrasound scans are conducted to identify the exact internal problem of the patients. These
scans are considered to be very safe, but there might be several issues and negative effect of
ultrasound on the patients especially on the pregnant ladies. Now we will study the concerns
and negative effects of using ultrasound scans.
Safety during ultrasound scan process
The ultrasound scan is a safe procedure which usually takes 15 to 45 minutes approximately.
Mostly all the practicing doctors have ultrasound devices. In order to provide proper safety
during such process, the scans are performed only by the doctor or the professional sonographer.
Many countries provide special training to analyze, modify and change the image quality of a
scan to sonographers. These people should have all the required knowledge and training of
different sections of medicines like anatomy, pathology and physiology.
Safety on the basis of types of Ultrasound scans:
The safety of ultrasound scan also depends upon the type of scan whether it is internal and
external scans. IT is very important to extra precautions while carrying out the internal and
endoscopic ultrasound.
External ultrasound – Is done by the doctors or sonographers by putting a lubricating gel on the
patients’ body and then placing and moving the transducer on the body. Example- external
ultrasound is used to examine the heart, abdomen or foetus in the uterus.
Internal ultrasound - internal ultrasounds are used when the clear image does not appear
through external ultrasound. In such cases, the transducer is placed inside the body of the patient
to have a clear image. In females, the device is entered through vagina and in males, through
rectum.
Endoscopic ultrasound - an endoscope is inserted into the patient's body, through his/her
mouth. This type of scan is used to have a clear image of the esophagus, chest lymph or the
stomach. At the tip of the endoscope, a light as well as ultrasound device is fitted which captures
the clear image. Before starting the procedures, painkillers or sedatives are provided to the
patients.
External ultrasounds are completely safe and comfortable, but there is a slight risk of bleeding or
infection and discomfort with the internal ultrasound process (Nordqvist, 2015).
Biological effects of ultrasound
Ultrasound scans uses sound waves and frequencies to capture the image of the internal organ of
the body. These waves can affect the tissues of the bodies of human as well as animals by two
ways:
1. The scan uses waves which heats the body part. Heating temperature up to 2.5º Celsius
(4.5º F) does not harm the patients. But, the use of Doppler ultrasound has adverse effect
on the health of the patient as it uses continuous waves which increase the heating
temperature.
2. Cavitation: Is a process of collapsing the gas pockets found inside the tissues. The small
pockets of gas vibrate and collapse due to the exposure of heat during the ultrasound
scans.
According to a study conducted on animals/ newborn rats in 2001:
Ultrasound scan are considered to have a negative effect on the nervous system. These scans
affect the brain development and damage the myelin which covers the nerves.
It also reduces the no. Of cell division and effects the learning abilities of rats in adulthood.
Effects of Ultrasound on the Human being
Studies on humans shows that the effects of ultrasound scan leads to miscarriage, premature
ovulation and delivery, prenatal death, dyslexia, poor development, hearing problem, speech
impairment etc. According to a study, the babies who have gone through five or more Doppler
ultrasound, have 30% more chances to develop growth retardation, poor health and weak
nervous system.
According to many women who have gone through the ultrasound scans had bad experiences.
Many women, felt uneasy and uncomfortable during the scans. Ultrasound scans may lead to
miscarriages in some women. Many people advice against having an ultrasound scan. Some
women have experienced heartache, which takes years to cure, during a difficult diagnosis
process.
There are certain types of ultrasound scans which leads to infection due to unhygienic
conditions. During the transvaginal; transrectal; transesophageal scans, it is very important to
maintain the hygienic condition. The devices to be used in these scans must be properly
sterilized, sanitised, and antiseptic as during such scans the transducers are entered in to body
through vagina, rectum or oesophagus/throat. These scans have a higher risk of internal bleeding,
pain, and infection. The risk increases for the pregnant ladies as the infection or unhygienic
device could do more harm to the baby then the mother. Unborn babies/ foetus are most sensitive
and prone to infection then the new born babies. Infection or bleeding during these scans could
even lead to death or medical complications for the mother and the baby. Proper Hygiene
practises must be followed during these scans (Acton, 2013).
Ultrasound scans can also lead to few biological changes in the human beings. These Biological
changes may occur in two forms during the Obstetric ultrasound: Thermal and non thermal/
mechanical.
Thermal bio effects are those biological changes which are related with the rise in the
temperature in the targeted area or tissues. Though the temperature is absorbed by the body but
sometimes, the body could not absorb all the heat (if temperature rises) and can damage the
targeted tissues.
Non thermal/ Mechanical bio effects: refers to those biological changes with occurs due to the
treatment of ultrasound without raising the temperature. The examples of mechanical bio effects
are cavitation, radiation forces and free radical generation (Radomski & Latham, 2008).
Table 1: Use of the ODS for maintenance of safe index values during ultrasound
Overall, the ultrasound scans seems to be safe. Doctors and the sonographers must conduct while
keeping in mind the safety aspect and procedures. All these practitioners must use/follow safe
technology and safety mechanisms like ODS. It is the responsibility of the sonographer to ensure
the safety of the patient. He should regularly study the Thermal (TI) and mechanical index (MI),
during the ultrasound to make sure that the value of these indexes must not rise to more than 1%.
And if it rises to more than 1 percent, then he must adjust it accordingly.
Safety during Ultrasound scans can also be maintained by following the radiology principle
ALARA (As Low As Reasonably Achievable). It means that the sonographers must conduct
these scans in the minimum time using minimum heat and ultrasound exposure to detect the
exact problem or issue of the patient. Ultrasound devices have come a long way. It has been
continuously evolving and developing. Machines with new technology, more power, minimum
risks and clear diagnosis images are being developed and expected to be launched in the markets
in the future. These machines will provide better diagnostic quality, lesser risk and maximum
safety to the patients. The developers must try to create such machines which do not cause any
negative effects as discussed above. This will provide more safety to the ultrasound scans
(Kremkau, 2014).
Guidelines for the safety of ultrasound process
The guidelines of the medical association clearly states that the ultrasound scans must be done by
fully trained staffs who know all the safety measures. Medical professionals complete the scan
process as soon as possible. Expert doctors or Sonographers are aware about the complete
process of Ultrasound. They know all the important facts like:
 Doppler, specifically transvaginal, is not used in the early weeks of pregnancy.
 The heat affects the bones more than the tissues, thus the scan is not carried out on the
growing foetus. The babies skull is a very sensitive part, thus the device must be placed
away from that area.
 The process should not take longer duration. It must be done very quickly.
 It must not be done when the person have fever.
According to the medical experts- Ultrasound scan doesn’t provide any harm if performed
according to the guidelines. In fact it is very helpful for the doctors to detect the actual condition
or problem of the patient (Baby centre, 2014).
CONCLUSION
From the above report on Ultrasound, all the misconceptions have been removed as the report
clearly explains that the Ultrasound scans are 100% safe. The different types of scans, devices,
process, usage, guidelines etc have been discussed. It has been very surprising to know that
ultrasound is used in so many medical treatments. It’s a boon for the medical science. It has
made the life easy for doctors and patients, as with the help of ultrasound they are able to find
out the exact problem f the patient and the treatment can be done accordingly.
REFERENCES
 Acton, A. (2013). Advances in Hygiene Research and Application. ScholarlyEditions
 Baby centre. (2014). Are ultrasound scans safe? [Online]. Available from:
http://www.babycentre.co.uk/a1014487/are-ultrasound-scans-safe
 Bhargava. (2002). Principles and Practice of Ultrasonography. Jaypee Brothers
Publishers
 Carlo Di Mario, Dangas, g., Barlis, P. (2011). Interventional Cardiology: Principles and
Practice. John Wiley & Sons
 Dr. Buckley, S. (2005). Ultrasound Scans- Cause for Concern. [Online]. Available from:
http://sarahbuckley.com/ultrasound-scans-cause-for-concern
 Eklöf, B.,Lindström, K., Persso, S. (2012). Ultrasound in Clinical Diagnosis. OUP
Oxford.
 Frontera, W. (2007). Clinical Sports Medicine: Medical Management and Rehabilitation.
Elsevier Health Sciences.
 Haller, J. (1998). Textbook of Neonatal Ultrasound. Taylor & Francis.
 Kremkau, F. (2014). Sonography Principles and Instruments. Elsevier Health Sciences
 Machi, Staren. (2005). Ultrasound for Surgeons. Lippincott Williams & Wilkins
 Nordqvist, C. (2015). Ultrasound Scans: How Do They Work? [Online]. Available from:
http://www.medicalnewstoday.com/articles/245491.php?page=2
 Radomski, M., Latham, C. (2008). Occupational Therapy for Physical Dysfunction.
Lippincott Williams & Wilkins
 Stadtmauer, L., & Tur-Kaspa, I. (2013). Ultrasound Imaging in Reproductive Medicine.
Springer Science & Business Media
 Togawa, T.,Tamura, T., Oberg, P. (1997). Biomedical TRANSDUCERS and
INSTRUMENTS. CRC Press.