Basic EV Tips: how to begin

Basic Endovaginal Tips – How to Set Up and Begin

Endovaginal scans were initially very intimidating scans for me as a student, mostly because I didn’t have any hands on practice while in school.

My first attempt at them was out in the world, working nervously under the watchful eye of my Clinical Instructors. Fortunately, I had a great Clinical Instructor who taught me many of the skills and tricks to performing an EV scan quickly, thoroughly and hassle free, that I still use today.

Here are the basics for EV setup and starting the scan:

If you have an idea that an EV may be necessary for your next scan, set up your room so that the items needed are close at hand. Have clean gloves, the transducer cover, gel and transducer all together in one drawer or set out on the counter.

Inspect your EV transducer handle so you know how to hold your hand in both the sag and trans positions.

Make note of any raised markers for your fingers to feel when under the sheet when you cannot see the handle.

This way your prep will be quick and easy and you will be free to focus on the scan and pathology.

Show her the transducer and do a quick explanation. Information is powerful and it will help to assuage her fears and help her to relax.

I usually hold up the transducer, indicate how nice and narrow it is, that it will only go in a few inches, that the gel on top is cold, but that is usually the worse part of the exam.

Ask her for permission to proceed with a simple “Does this sound okay to you?”

Have her help you insert the transducer. This is both to make it easier for you and more comfortable for her, because with her guiding the transducer she has control over the pressure and angle of entry.

Ask her to reach one hand under the sheet and you will pass her the transducer from below (between her legs). Keep your hand on the end of the handle and let her guide the front in.

When you can see that it is far enough in from the active image on the screen, let her know that she can let go and you will take over from here.

4. Once the transducer is in properly ask her if she feels alright.

Be sure to ask a couple of times during the scan to keep an open dialogue and also give brief explanations of what you are going to do next, whether it’s sweeping from side to side as you assess or pressing a bit firmer into the adnexa to see ovaries.

It’s important for her to feel comfortable and calm and open communication is one of the best ways to ensure that. 

And now you have begun! As with all things, practice will make perfect, but when you combine your practice with preparation, explanation and communication you will create some pretty awesome ultrasound, the kind that you feel confident doing. 

Remember, you can do this and you can do it well!

Happy Scanning!