Southern Health Diagnostic Imaging

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MMC Ultrasound Department
Procedures and Preparation

1. Abdominal Ultrasound incl. Abdominal Doppler / Duplex

• Aorta

• IVC

• Iliac arteries/veins

• Renal arteries/veins (with the exception for renal / pancreatic transplants)

• SM Artery and Coeliac axis

• Portal / Hepatic / Splenic Veins (Portal HT Doppler series)

Preparation
Teenagers / Adults: 6-8 hour fasting (preferably an 8 hr Fast)
Paediatrics: 6 hours
Neonates: 6 hours with glucose feeds allowed.

Exceptions

• Neonates investigation for possible Pyloric stenosis:

  • require 2 hours fasting and the patient (parents) brings with them a feeding bottle of glucose/sterile water.

• Paediatrics with possible intussusception - no specific fasting required.

• Renal and renal/pancreatic transplant studies (requiring full bladder only.)

Diabetic Patient
The Ultrasound Department needs to be notified if the patient suffers from diabetes, as we will try and accommodate the patient with an early morning appointment, to minimise the patients fasting time.

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2. Renal Ultrasound
Preparation

Renal Ultrasound Scan, Right Kidney in a 5 year old   Click to enlarge image

Full Bladder required (but not overfull!) Adults/Teenagers: Patient is not to urinate from 1 hour or to have their urinary catheter clamped off from 1 hour prior to their Ultrasound appointment. Paediatrics: Full bladders preferred. Non-fasted and well hydrated. NO FIZZY DRINKS PRIOR TO ULTRASOUND! Non-toilet trained children / Neonates: well hydrated, ie: all neonates should be fed prior to their ultrasound appointment to help make them more settled for their examination.

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3. Pelvic Ultrasound
Preparation

• Paediatrics/neonates: Full bladders are preferred in order to demonstrate the ovaries and uterus.

• All male patients, neonates, children and adults whom have never been sexually active: Full Bladders are required.

Drinking suggestion: drink 3 glasses of fluid including tea and coffee with the exception of fizzy drinks, starting one hour before. However if the patient becomes too uncomfortable with their full bladder prior to their ultrasound appointment, they are encouraged to micturate a little until they are more comfortable. If they are well hydrated they won’t take long to refill their bladder again.

Transvaginal ultrasounds are recommended on all Gynaecological Ultrasound examinations on patient’s 18 years and above, providing they have been sexually active. The transvaginal ultrasound is only performed provided the patient consents to the examination.

Obstetric scans may require a transvaginal ultrasound to obtain better anatomical and pathological detail, ie: ? viability in the 1st trimester, foetal anatomy, placental location, cervical assessment, etc.

In all pelvic ultrasounds, the kidneys (and the adrenal glands in paediatrics) are scanned as a part of the routine pelvic examination.

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4. Obstetric (Pregnancy) Ultrasound
Preparation

• No preparation is required.

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5. Small parts / Musculoskeletal Ultrasound
No specific patient preparation is required.

Patients who require an x-ray of the area to be examined with ultrasound, are recommended to have it done prior to their ultrasound scan, and bring their x-ray films with them to their ultrasound appointment.
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6. Vascular Ultrasound
The following vascular studies require no patient preparation:

• Carotid arteries

• Neck veins

• Subclavian arteries / veins

• Thoracic Outlet

• Radial arteries – pre coronary artery bypass grafts

• Upper / lower limb arterial

• Venous Arm Mapping – for A-V Fistulas

• Venous Leg Mapping – legs pre-coronary artery bypass grafts or vascular intervention

• Upper / lower limb venous for possible deep vein thrombosis or possible Venous incompetence / insufficiency lower limb only.

To the referring Clinician: when requesting upper/lower limb vascular studies please be quite specific which type of study you require and the clinical indication, as these examinations require different time allowances and specialised ultrasound expertise.

The following vascular studies require fasting for 8 hours:

• Aorta

• IVC

• Iliac arteries / veins

• Renal arteries / veins (with the exception for renal / pancreatic transplants)

• Mesenteric arteries / veins

• Coeliac Axis

• Portal / Hepatic / Splenic vein Dopplers (Portal HT Doppler series)

NB: The Ultrasound Department needs to be notified if the patient suffers from diabetes, as we will try and accommodate the patient with an early morning appointment.
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7. Intervention Procedures

• Renal Biopsies

• Liver Biopsies

• Thyroid Biopsies

• Breast Biopsies

• Ascitic Aspiration/Tap/Drainage

• Pleural Aspiration/Tap/Drainage

• Aspiration/Drainage of an Abscess

• Paediatric biopsy/Procedure under ultrasound guidance

• Joint injection

• CVS (chorionic villus sampling)

• Amniotic fluid (Amniocentesis)

• Placental Biopsy

• Foetal Blood Sampling

• Ovarian Cyst Aspiration

Preparation
The patient will be required to arrive 1-hour prior their intervention ultrasound procedure so that they can be fully prepared and the patient’s blood clotting results can be checked.

Patients may be required to fast for 4 hours prior to their ultrasound procedure and also may require blood tests for their INR clotting value. This will need to be discussed with the ultrasound staff at the time of booking. We also need to be advised if the patient is currently on Warfarin, Heparin and Clexane or any other blood thinning agents. The acceptable INR level for an intervention procedure is < 1.3 (in the case where the patient has a higher INR, the referring doctor needs to discuss this with radiologist before the patient can be booked in.)

Day Procedures
All Outpatients who are having an Ultrasound Guided Biopsy / FNA / Ascitic and Pleural Tap should be booked into the Diagnostic Imaging Day Ward or the MMC Day Treatment Centre so that the patient can be monitored post procedure.

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