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You need to either print or save your ultrasound images if you are billing out for them. In order to ensure that your records are kept properly you will need two forms of documentation on each ultrasound exam. One piece of that documentation is your actual report on the findings or results of your exam or the ultrasound procedure you conducted. (You can make use of our sample report templates here on this site.) The other piece of documentation you need is the annotated image itself, either printed out and kept in the patient’s chart, or saved digitally and stored on your computer or in your EMR.

And keep in mind that it can’t hurt to both print your images and save them digitally. The images you are saving are valuable, and having both a paper copy and a digital copy — or a digital copy archived on two different computers — is only making everything safer over the long-haul.

Printing Your Images

If you have an ultrasound printer and you are keeping paper charts, you will simply want to press Print at the end of your procedure and get a thermal print-out to tape to a piece of paper and stick in the patient’s medical chart. You can either tape the print-out to the ultrasound report itself, or you can create a general template page you can print out and make copies of, so your assistant or nurse can easily take care of this for you. (You can download a very simple form like this by clicking here or right-clicking the link and choosing Save Target As and then saving the file to your computer’s desktop.)

If you do not have a thermal ultrasound printer, you can still move the images to your computer and print from there. Just keep in mind that printing out ultrasound images on a normal computer printer is going to mean going through a great deal of ink. That is why ultrasound printers print to thermal paper. If you see yourself printing more than one or two ultrasound images a day, it makes sense to invest in an actual thermal ultrasound printer.

(Note: if you do have a thermal printer, remember the value of printing out a second copy to give to the patient to take home with him. You don’t want to do this all the time, but if you have an especially good image and you think the patient interested, it can be a good practice to give the patient a copy, being sure to first staple two of your business cards to the back, and also taking a moment to explain a little of what is in the image to the patient. This can lead to a lot of referrals!)

Saving Your Images Digitally

Even if you keep paper charts, saving an image digitally as a back-up is a great idea. And if you are not keeping paper charts, if you are entirely in EMR, you absolutely needto keep your images saved digitally.

Fortunately, it is quite easy to do, as long as you stick to a consistent system.

Having well-organized archives of your images, each consistently and accuratly named, also makes your records all the more bullet-proof.

Two Approaches To Saving Images Digitally

There are two ways to save images on your CTS-7700+. There is the long version, which has multiple steps but gives you the greatest control over the name of the resulting image file. And there is the short version, which requires a short one-time preparation and assigns numbers for the file names, but is lightning quick — and therefore quite popular.

Quick safety tip: While you will be saving images to USB drive, you may have gotten a USB drive with the ultrasound itself (it would say "SIUI" on it, possibly "www.siui.com",and it’s probably white or silver); if you did receive one of these with your ultrasound, do NOT use that one to save images. The USB drive from SIUI has the reboot recovery software on it. Store that somewhere and don’t use it. Literally put it in an envelope, seal it, and write on it RECOVERY SOFTWARE FOR ULTRASOUND. You do not want to use that flash drive to store images. Instead use any other USB drive you happen to have (usually 2-gig or 1-gig or even smaller is perfectly fine). Ideally use the USB drive we sent you separately with your supplies (probably a 2-gig drive).

THE LONG APPROACH (with the greatest control over naming the image file)

If you have your USB drive plugged into the back of the ultrasound, when you press DISK (on the far left of your ultrasound console), you should see a little menu pop up with some options in it. You don’t want to pick what seems at first the obvious choice (“Write Image” or “Write Image Quickly”) but rather you want to choose OTHER OPTIONS. If you “write quickly” it’s certainly fast — but you end up with an image saved with a generic file name on the hard drive of the ultrasound itself. That’s not the end of the world, but ideally we want to save to the USB drive, so we will follow these steps:

  1. Make sure your USB drive is plugged into the back, then press DISK (button on the left side of your ultrasound console). When the little box comes up, the first thing to ALWAYS do is scroll to the bottom option and highlight “Other Operations” in the menu and press Enter.
  2. In the next box that comes up, you will choose where you want to save the image. Pick USB DEVICE and press Enter.
  3. In the next box it will already be highlighting WRITE IMAGE. Just press Enter. (If you were pulling an image back up that you had already saved to the USB drive, you would scroll down to the second item on the list: Read Image.)
  4. Now you get to select the image file type. Select JPG as your file type and press Enter. (If you want to save the full cineloop as a short video file — probably not something you will do often — select AVI instead.)
  5. You now should be highlighting either two little dots or possibly an arrow. These mean "root directory," which is what you want, so just press Enter again. (Any other images you currently have saved on the USB drive will also be displayed here, below the two dots.)
  6. Now you have the field in which to type a name for the image. You can’t use commas or any weird characters, but I do recommend last name and first name, with the date either preceding or following the name, maintaining a consistent format. (If you are following this approach to saving your images, you can read my suggestions on naming images by clicking here.)
  7. With the file name typed in, press Enter.
  8. After a short pause, the box should disappear and you should be back to looking at your frozen image.

It looks like a lot of steps, but really three of the steps only require scrolling down a little and pressing "Enter," and three steps don’t even require any scrolling — just the "Enter" button. So it goes by pretty quickly, and after you have done a few, you should be able to zip through the saving process in a few seconds. If it still feels as if it takes too long, you can likely train your assisting nurse to handle these steps for you while talk with the patient and wrap things up … or you can try the short version described below.

I recommend reviewing the steps on how to properly transfer images from your USB drive to your computer, as well as a few quick tips we have put together on ensuring that you are not risking corrupting any files on your USB drive during the transfer. For notes on how to safely use your USB drive click here. And for notes on how to move images using your USB drive in general, click here.

 

THE SHORT-AND-EASY APPROACH

This approach requires making a one-time adjustment to your save settings, but after that saving your images is literally as easy as pressing "Disk" and then "Enter." And that’s it. The only challenge with this approach is that it assigns random numbers for file names on your saved images. You will need to open them up on your computer and look down to the Patient Data at the bottom of the image to know which patient the image belongs to. If you can adjust to that, though (or assign that step to a nurse or assistant at the end of the day), it’s certainly far quicker, making capturing a sequence of images one after the other much easier to do when you are limited in your time.

The One-Time Set-Up

  1. Start by pressing DISK (located on the left side of your ultrasound console). When the little box comes up, scroll down to "Store Settings" and press "Enter."
  2. In the menu that now comes up you can use your trackball to select the settings you wish to choose and then press "Enter" to select them. These are the settings you want to highlight and select: Image Format = "JPEG." CINE Format = "AVI." Store Location = "USB Disk." Folder Format = "Patient Name / Date." Save Location = "Hard Disk." With all of those set, go to the bottom and highlight "OK" and press "Enter." This should take you back to the little menu. Press "Esc" to escape out of that. You’re all set now.

The Quick-and-Easy Save Procedure

From here on out, as long as your USB drive is plugged into the back of your ultrasound, when you freeze an image and make your measurements and annotations, and you want to save it — simply press "Disk" and with the first item on the menu ("Write Image Quickly") selected, just press "Enter." That’s all there is to it. Your screen should flash "Saved Successfully." How’s that for quick and easy? Simply press "Freeze" (and perhaps "Clear Text" and "Enter" to get rid of your annotaitons and measurements) and return to scanning for your next image.

How the Image Files Are Arranged and Named on the USB Drive

Using this system of saving your images takes away your ability to give the image a specific name at the time you save it. (That’s part of what makes it so much faster, of course.) Instead, the ultrasound makes up a numerical sequence as a name for the image and stores it on your USB drive.

If you are using this system, I recommend keeping a folder named "Ultrasound Images" on your computer, and it will be into this that you or an assistant will drag the day’s images from the USB drive. Once the images are moved over there, you can double-click each, have a quick glance at the patient’s name at the bottom left, close the image being viewed, and then right-click the file and select "Rename" and give it an appropriate name.

For some ideas on how I recommend naming your images, click here.

And for some pointers on the proper use of your USB drive in transferring images, and the important tip on how to safely remove the USB drive from your computer after transferring images, please take a moment to click here.

Using this system of saving your images you will eventually have a master ultrasound images folder containing all of your saved images, ideally renamed to include the patient’s name and the date on which the scan was captured. From here you can copy them over into your EMR system if you like, although I recommend keeping a master "Ultrasound Images" folder archive as well.

 

Saving Your Cineloop as a Video

A final note … on saving your entire cineloop as a video file: you can do it, but you probably won’t want to do it all the time — in part because it just takes a long time to save, and in part because you cannot annotate or make measurements on the resulting video file. For your documentation, stick with frozen images and annotate them well. But if you do want to save your cineloop as a video, here is how … Press "Disk" and select "Disk" at the bottom of the menu. Now choose "USB Device" and then "Write Image" (as normal), but then for file type choose "AVI." This will give you a video file that you can watch on any computer. (If you choose "CINE" as your file type, you will only be able to replay the loop on your ultrasound itself.) Now choose the two dots for the root directory and press Enter again, and give your video a name at the bottom. When you press enter at this point it will take a little while to save the entire loop, but when it’s done, you should just be able to press "Esc" to get rid of the little menu box and you will find the .avi video file on your USB thumb drive.

 

 

Quick Links: Post-Capture

  1. Back up in the Cineloop
  2. Make your Measurements
  3. Annotate the Image
  4. Print and Save the Image

 

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