Training in Carotid Duplex Scanning.

Hi Everyone
My name is Karen and yes I like a drink or two hic! I run the vascular lab in Morriston Hospital, Swansea and I have a little problem that I would like some feedback / comment on from the membership.

Nearly all the local district hospitals within the South and West Wales have contacted me recently asking for help with regard to carotid duplex scanning. Management have told unsuspecting ultrasonographers locally that because of the new national stroke guidelines etc that they will have to provide a carotid doppler service just as they now provide a DVT service. The sonographers are all crying help! Understandably and asking for help with training etc. This is going to happen whatever but obviously since these patients may all end up in Morriston for ? intervention it would be better all round if imaging was standardised regionally to reduce 1. mistakes and 2. repeating scans unnessarily.
Have any other members been asked for their hepl and advice with such matters and what if any was the outcome?

I look forward to any advice and helpful suggestions

Thanks
Karen

Hi Karen

This is going to be a big issue!! We have been asked to set up a 7 day service to start later in the year. My worry is that if sonographers are not trained properly, there may be patients who have significant disease that is missed and therefore not sent on to your unit. I think that training and funding is a big issue and needs addressing urgently. I guess many of us will be in a similar position to yourself.

Cheers

Tim hartshorne

I wonder if some kind of 'single modality' training and exam could be developed by the SVT, so the SVT can maintain control and set the high standards that need to be in place for accuarate and safe practice.
I guess there are many sonographers or radiographers out there who maybe only scan DVT's or carotids along with other lists such as obstectrics etc.
A single modality exam for carotid scanning will ensure non AVS's will be able to prove a certain standard has been reached, and this can be the same for the whole country

Resurrecting this topic, I just want to mention a training day we ran in Belfast yesterday. It was entitled "Imaging the Carotid Arteries:An Update" and we sent the flyer around all the hospitals in N. Ireland. Our target audience was the sonographers & radiologists who already scan carotids, so I was very pleased when they all came along. That may have been helped by the fact that we got enough sponsorship to make registration free for them, gave them a free lunch and also got CME points agreed by the RCR, but we did put together good speakers for the morning meeting, including Crispian who very kindly came over to talk through the national recommendations. In the afternoon we ran a 2 hour workshop on carotid ultrasound imaging. We got 70 delegates in the morning and 40 or so stayed on for the afternoon.

They took it all in and all seemed prepared to adopt the new recommendations without argument. There was support for forming a group of lead sonographers from all the trusts to continue to meet with us and try to establish consistency across the province. Maybe I'm too easily pleased but I just found it a big step forward.

Earlier this year, we got an agreement with the radiologists at a regional stroke strategy meeting that we measure stenosis on CEMRA, CTA and ultrasound scans using the NASCET method. I think that was mostly happening anyway, but it was still encouraging.