If patient is capable, __________ _________ must be obtained from patient:

• _________ to __________

• in a __________ understood by patient. Use an approved __________ if necessary.

1. identify themselves, the procedure ordered and what their role in the procedure is.
2. identify the patient by checking the patient's wristband.
3. If wristband is absent, identify the patient in an appropriate manner. It is preferable to get the patient involved in the process by asking them their name and date of birth. If the patient is sedated, call the nurse and have patient transported back to their room to get a wristband. (DO NOT CANCEL ORDER).

It is best to assume that every patient is __________.

• Use __________ __________, protecting both the patient and the sonographer.

• wash hands __________ and __________ the exam.

• wear __________ and other __________ as deemed necessary.

• Kindness, humanity and respect are __________ values in medicine.

• You can provide __________ by providing privacy and interactions which make patients feel __________, comfortable and in __________.

• patients' impaired health and older age rendered them __________ to a loss of __________.

• __________ studies the interaction between the sonographer, patient, and __________ to optimize the well being of the __________.

• more than _____% of sonographers experience pain from __________ injury related to work.

• approximately _____% end their career as a result of such injury.

• wrist support braces
• transducer design
• control panel and monitor articulation, chairs, beds and support cushions

The facility is responsible to develop __________ and __________ for ergonomics and sonographer health-__________ __________ __________.

• keep your arm __________ to the body.

• stay __________ to the patient.

• position the monitor __________ in front of you and at __________ level.

• __________ the extent of twisting or bending over.

• hold the probe using a __________ grip rather than just a __________ grip.

• keep the wrist in a __________ position.

• use proper __________ support.

• develop __________ & __________ programs

• effectively __________ patients

• implement __________ and __________ programs

The science of identifying and measuring those characteristics of an US field which are especially relevant to its potential for producing biological effects.

What are these characteristics? Not sure.

Very high intensities of US cause damage to biologic tissues.

At standard intensities, there are no known cases of bioeffects or tissue injury in diagnostic imaging.

SPTA

100mW/cm² unfocused

1W/cm² or 1000mW/cm² focused

• Propose a specific physical mechanism that could produce bioeffects.
• Theoretical analysis to estimate scope of bioeffects at various exposures.
• Identify "cause-effect" relationship.

• Acquire/review data from patients or animals.
• Correlate exposure and effects.
• Identify "exposure-response" relationship.

The Mechanical Index (MI) is a number proposed in the AIUM guidelines that relates to cavitation. MI is more likely to produce cavitation with:

1. peak rarefaction pressure
2. lower frequency

MI= peak rarefaction pressure/√frequency

Bubbles tend to oscillate when exposed to acoustic waves of small amplitude. Bubbles do not burst. Bubbles that are a few micrometers in diameter double in size. Bubbles intercept, reradiate and absorb acoustic energy.

Effects: Shear stresses & microstreaming in surrounding fluid.

Transient Cavitation; aka inertial cavitation, normal 

(TIN)

Highly localized violent effects:

• enormous pressures--shock wave, mechanical stress.
• colossal temperatures--thousands of degrees