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ACUSON S2000 ABVS Instructional Video- Patient Positioning

Learn more about how to properly position your patient when using the ACUSON S2000 Automated Breast Volume Scanner.

The Acuson S2000 automated breast volume scanner or abvs from Siemens Healthineers is particularly valuable for imaging patients with dense breasts. A significant challenge in breast lesion evaluation. This video will demonstrate how to properly position the patient, apply the coupling lotion or gel and correctly position the transducer and the operator to ensure the most accurate volume acquisitions. A typical Abscess exam on an average patient consists of three standard views, AP, lateral, and medial. Occasionally, additional views are required to ensure complete coverage of the breast. To begin, there are a few accessories required to ensure a successful exam. You will need a stabilizing membrane, lotion or gel. A spatula or tongue depressor, a positioning wedge, and the proper bed. It is necessary to use a bed that can be easily adjusted up and down an Trendelenburg or reverse Trendelenburg. We use an ultrasound lotion instead of a gel, mainly because it has fewer air bubbles, but it also helps reduce artifacts and allows for a smoother movement of the transducer. First, position the patient. Once the patient is positioned for the first view on the right breast, the patient will maintain that same position throughout all three views. In order to flatten out the breast tissue evenly, it is necessary to roll the patient and place an angled sponge behind the back. The sponge supports the patient an helps minimize movement during the acquisition place the patients arm in such a way that allows the majority of the breast tissue to be imaged. Sometimes the arm will be completely up or partially up or even down by their side. Just keep in mind that the breast tissue should not be pulled away from the center of the breast to verify the proper position, go to the end of the bed and look to make sure that the nipple is pointed towards the ceiling and the breast tissue is evenly distributed. Next, apply the lotion over the breast in a thin layer and add a little extra on the nipple to help reduce the inherent nipple artifacts. In order to spread the lotion evenly without rubbing it in, use a tongue depressor or small spatula. Please remember, this is ultrasound and imaging artifacts still exist. Therefore, it is very important to have good coverage over the entire breast. For the first EPI view, bring the transducer pot across the body and center it over the central portion of the breast. Attach the membrane and choose the appropriate Cup size. Using the pink arrow in the middle of the transducer as a guide center over the breast, but not necessarily the nipple. Since the nipple is not always the center of the breast lock the transducer pot in place and apply a small amount of compression using the automatic compression button. That's usually no more than one to two steps. Instruct the patient not to talk and to breathe normally. Then begin the acquisition. On the touch screen monitor, observe that the transducer maintains contact to ensure adequate coverage. As you can see here in the center of the image there is a dark shadow which represents the nipple. This also shows that there is good coverage from the lateral to the medial aspect of this breast. Adjust the nipple marker and accept the image. Now that the right AP is completed, let's transition to the right lateral view. Once again, do not move the patient re distribute the remaining lotion from the medial to the lateral aspect of the breast, and if necessary, apply a little more lotion. If the arm is down, reposition it so that it is up and away from the body to enable the transducer to have access to acquire most of the axilla retail. It's critical to not put the arm up too high because it will pull the breast tissue away from the breast. So ideally move it just enough so that the breast tissue is evenly distributed. Take the transducer an use it as a paddle. Rotate the transducer to align with the Midaxillary line an not against it. Place the transducer pod on the breast and push the breast tissue away. Slowly rolling it down to flatten the dense tissue while still maintaining the contact on the lateral edge. Lock it in place and add a little compression to maintain that contact, looking again at the monitor observed to see that there is coverage, this time from the lateral to the medial portion of the breast. To acquire the last view, which is the right medial, apply a little more lotion over the nipple area and once again re distribute the lotion from the lateral to the medial aspect. For this view position, place the arm down. Notice how placing the arm down really pulls the breast tissue back down evenly over the body. Just to reiterate, patient positioning is highly dependent on the patient's body, habitus and breast size. Place the hands underneath the handles to get a better grip on the pod to use it as a paddle. Place the pot on the sternum. And line it up with the middle of the chest, center it over the breast and slowly pull the tissue while simultaneously rolling the transducer down. Lock the pod into position and add a little pressure. It is common to not have contact over the lateral aspect of the breast. This is perfectly fine for this view because we are mainly interested in the medial tissue. Now that all three views of the right breast are completed, the system automatically transitions to the left breast using the easy scan protocols seen here on the screen. The system is automatically set up for the left AP view. Please remember it is not necessary to move to the opposite side of the bed to position for the left breast. This concludes the video demonstration.

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  • ACUSON S2000 ABVS Instructional Video- Patient Positioning