sonographer led training neck fna...2019/11/04 · sonographer led training neck fna claire lindsay...
TRANSCRIPT
SONOGRAPHER LED TRAINING NECK FNA
CLAIRE LINDSAY
SONOGRAPHER
NHS GGC
THE SWANSEA HEAD AND NECK ULTRASOUND WORKSHOP
TRAINING – NECK SCANNING
RCR GUIDELINES
• Thyroid scanning: normal/abnormal, BTA scoring system of thyroid nodules.
• Salivary glands: obstructive patterns, calculi, salivary neoplasm (benign/suspicious).
• Cervical lymph nodes: comprehensive examination of groups I-VI, normal, reactive, malignant
• Major vessels: normal anatomy, normal variants, thrombosis
BTA SCORING
TRAINING - FNA
FURTHER LOCAL TRAINING
• Attend local allergic reaction training
• Resus training
• Direct observation, direct supervision, indirect supervision
• Addition to Lidocaine PGD
LABORATORY
• Slide preparation for optimum sampling
• Stains
• Under the microscope
RCR GUIDELINES
• Accurately perform USFNA of neck masses with competent sample preparation
• 20-30 procedures documented
• Varying sizes of lesions
• Understand the practicalities of ultrasound
• Demonstrate awareness of consent and contraindications
FNA GUIDELINES
• 70% of all FNA should be diagnostic on cytology assessment.
• Blood contamination
• Low cellularity
• Poor slide preparation
SOP’S
• Neck scanning
• FNA
• Inclusion in lidocaine PGD
• Audit
• Attendance at MDT
CHALLENGES
• Pathology
• Structures of the neck
• Local anesthetic
MY EXPERIENCE
• Plain neck scanning – familiarisation with anatomy and the ultrasound appearances of thyroid nodules
• Direct supervision
• Indirect supervision
• Dedicated weekly list