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Viewing Ultrasounds in the Patient File
All ultrasound scans can be viewed in the Ultrasound folder. Any ultrasound may be linked to a Treatment Cycle. When viewing the scans in the Ultrasound folder, they are organized according to Treatment Cycle. You may select the cycle from the dropdown to see all the scans associated with the cycle. Ultrasounds that are not related to a cycle (eg. Diagnostic scans, sonohysts) are normally associated with Cycle "None".
You can view all ultrasounds in the patient file by selecting the Display All Treatments option.
Baseline Scan
Navigate to the patient’s record and select the Ultrasound folder option.
Select the treatment cycle in which the scan is to be done.
USS data can be entered within the None [] – treatment option.
The top table in the ultrasound home page displays the list of scans planned and carried out within the selected treatment cycle. Planned scans are shown in grey. These scans are planned within the patients assigned treatment plan.
Confirm the scan to be carried out by left clicking the Scan button at the bottom of the screen and selecting the Confirm option.
Alternatively, place the cursor on the specific planned scan and press the F12 key.
Upon confirming the selected scan, the scan will display in blue text
Once the scan has been confirmed the scan details may be entered.
Note that unsaved data will display in red.
Click Save in the top tool bar.
Tracking Scan
Treatment plan events
Tracking scans are usually carried out to assess the development of ovarian follicles in a fertility treatment. It is usual, in IDEAS, to carry out tracking scans within specifically designed treatment plans. Treatment plans are designed by your clinic to manage fertility treatment events. Ultrasound scans (baseline, tracking and gestational scans) are programmed events which can be placed within treatment plans.
Tracking scan data entry
Tracking scan data can be entered into the patient’s record via the keyboard/mouse or by using a touch screen. The following section will describe how to enter images and follicle sizes using both methods.
Adding or Removing an Ultrasound
New ultrasound records can be inserted directly into the Ultrasound folder by selecting the New record icon in the toolbar. Pressing the Delete icon in the toolbar will remove the selected scan from the patient file.
Ultrasounds can also be added or removed via Treatment Plans. You can add or remove any ultrasound in Edit Treatment Plan (Treatments>Plan Details). Any scans in the treatment plan will automatically populate the Ultrasound folder.
Entering Scan Details
Complete the Scan details in the lower section.
Note: Planned ultrasounds will appear greyed out and read only if the date is in the future. If you are trying to enter information into a scan that appears read only it is either signed off or the record must be confirmed prior to data entry. Press the Scan button at the bottom of the screen and select Confirm. Alternatively, you can press F12 on your keyboard to confirm an ultrasound scan.
Select the Ultrasonographer and Investigation type from the dropdown. Available options are: Baseline, Tracking, Gestational, Saline Sonogram, Diagnostic and Other.
An External Ultrasound Site can be selected if ultrasound was done at another location without access to IDEAS.
Associate the ultrasound with the current Treatment Cycle. Select "None" if the ultrasound is not part of a treatment cycle. This treatment cycle may be changed after the ultrasound data has been entered. Therefore, in cases where the current cycle has not been entered in IDEAS or the wrong cycle has been selected, this can be changed following the scan.
Press the Follicle Tracking button at the bottom of the screen to enter follicular sizes in the scan. Select the Right or Left ovary. Two data entry modes are available for entering follicle size, Button Input and Table Input. In Button Input you simply select the follicle size from the list on the left. Table Input allows you to enter multiple dimensions for the follicle and will automatically calculate the average size. This also allows you to enter half sizes. Press Done once follicle entry is complete.
Press the Follicle Tracking button at the bottom of the screen to enter follicular sizes in the scan.
Select the Right or Left ovary.
Two data entry modes are available for entering follicle size, Button Input and Table Input. In Button Input you simply select the follicle size from the list on the left.
Table Input allows you to enter multiple dimensions for the follicle and will automatically calculate the average size. This also allows you to enter half sizes. Press Done once follicle entry is complete.
The follicle data is then summarized on the Scan Details tab. Enter Endometrial Thickness and Quality. Antral Follicle Counts may be entered directly in available fields for left and right ovary on the Scan Details tab if applicable.
Remarks can be entered either in Clinical Remarks or Persistent U/S Findings box. Clinical remarks are comments relevant to this scan. Entries in Persistent u/s findings area will be copied to the next scan.
Adding Ultrasound Images
Select the Images tab to upload images to the ultrasound record. Click the Import Images button to select images to upload from a network or external drive.
Signing Off an Ultrasound
In accordance with your clinic's policy, ultrasound records can be Signed off by staff with suitable authority and User rights.
Click the Signoff icon 
in the bottom left-hand corner of the ultrasound record to open the signoff window. Signing off will make the record read-only so further changes cannot be made.
Signoffs may also be preformed from the User Homepage or the Signoff tab on the Management Module.
Saline Sonogram
A standard ultrasound uses sound waves to image the shape of the uterus and other pelvic organs. A saline sonogram is an ultrasound that goes one step further by using sterile water to distend the uterine cavity to obtain more accurate information about fibroids, polyps, or the lining of the uterus.
This option allows you to enter the results of a saline sonogram.
Click Save in the top tool bar.
Ultrasound Report
For information on how to run a report on USS, follow this link Patient Query - Ultrasound Scan (USS) Report
Entering Gestational Scans
The Gestational US scan is often placed in the Follow up modules of the patient’s Treatment plan. However, it can also be placed in the Luteal module of the patient’s Treatment plan if you wish.
More than one Gestational ultrasound scan can be placed in the plan.
you can also select None in the Treatment cycle window if there is no associated treatment cycle.
The scan can be carried out and the data recorded as shown here
.
Click the New record icon in the toolbar to add a new scan to the Ultrasound Folder.
Select Gestational for Investigation type. Enter scan details.
The Gestation (wks/days) will update once the date of the scan has been entered. IDEAS calculates this date from the Treatment plan luteal day zero date. If the luteal day zero date is missing, the gestational age will be calculated from the LMP (Follicular phase day one).
Enter the number of gestational sacs and number of fetal hearts.
These numbers will determine the number of fetus records shown in the outcome table.
In the example below two sacs were visible on ultrasound but only one fetal heart was observed.
The outcome must be entered for each fetus.
Fetal heart beats, CR length, NT (mm) and BPD (mm) can be entered for each fetus in the right hand table
Note: These outcomes will be copied to the Cycle Pregnancy/Outcome folder for the cycle. They will be automatically updated based on subsequent scan results and can be updated manually with outcomes determined without u/s (ie. Live Birth).
The outcomes from the last gestational scan are copied to each subsequent scan and can be updated as required.
Note: The system can be configured to have the patient's blood type displayed on the Gestational Ultrasound record on the top right-hand side of the outcome table. Please contact Mellowood Medical to correctly configure this blood test result to display.
Ultrasound scans performed outside of treatment plans
Scans can be performed outside of a treatment plan.
Navigate to the Ultrasound folder and select the None option in the Treatment cycle drop down list.
To create a new scan, select New…
Select the desired investigation from the Investigation drop down window.
Proceed with the desired scan type as described in the remainder of this chapter.
Ultrasound Scan (Other)
This option allows you to record details of the scan and relevant Remarks in the area provided.
Click Save in the top tool bar.