Читать книгу Point-of-Care Ultrasound Techniques for the Small Animal Practitioner - Группа авторов - Страница 141

Hair is generally not shaved but rather parted for the best probe–skin contact with the use of isopropyl alcohol, and/or alcohol‐based hand sanitizer, and/or acoustic coupling gel. The author prefers the use of minimal amounts of isopropyl alcohol to effectively part the hair followed by alcohol‐based hand sanitizer. The strategy is much less noxious to your patient by minimizing the cold wetness of isopropyl alcohol and its fumes, especially when moved to an oxygen cage. Alcohol‐based hand sanitizer has the added benefit of being easily wiped off and it also evaporates quickly. Isopropyl alcohol should not be used if electrical defibrillation is anticipated because it poses a burn/fire hazard. The clinician should be aware that isopropyl alcohol may cause probe head damage (see Figure 4.13).

Pearl: By not shaving (or limiting shaving to small acoustic windows), the cosmetic appearance of the patient is preserved (happier clients), the exam time is lessened, and imaging quality is sufficient with most newer ultrasound machines (median AFAST time <3–3.5 minutes) (Lisciandro et al. 2009; Lisciandro 2011, 2012; Boysen and Lisciandro 2013).

Pearl: Maximize image quality by parting the hair and getting the probe head and its acoustic coupling medium in direct contact with the patient's skin to minimize air trapping, which is your imaging enemy because ultrasound does not transmit through air. Placing the probe head on a wetted mat of hair full of trapped air will produce a poor image (see Figures 5.1 and 5.2).

Pearl: Hold the probe in a way that is most comfortable while being able to fan toward and away from the table top while maintaining a longitudinal (sagittal) plane in patients placed in lateral recumbency. Holding the probe like a pencil for many who have learned to scan patients in dorsal recumbency usually becomes problematic at the DH view for the caudal vena cava. Holding the probe on top and keeping the thumb on the probe marker and a finger out to prevent drifting works best.