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