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Ultrasound Diagnostic Imaging Training |
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Ultrasound Diagnostic Training Institutes
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Ultrasound Diagnostic Training Institutes by State
Ultrasound, Sonography, and Medical Programs
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Ultrasound Diagnostic Imaging Details
Role of the Ultrasound Exam
Because imaging technology continues to advance, the clinic should periodically
determine that its ultrasound machine provides images comparable to or
surpassing the standard of care in the community.
There will be a medical indication and a physician's order for an ultrasound
exam.
The clinic will develop protocols for screening and selection of clients for
ultrasound exam.
The medical director may determine that certain medical conditions, gestational
age of the pregnancy or other parameters may exclude a client from an ultrasound
exam.
Each clinic will develop an informed consent form for the clients to sign which
specifically states the indications for the ultrasound and what information the
scan will and especially will not address.
The clinic must stress that the ultrasound exam does not constitute ongoing
prenatal care and resources for prenatal care will be given to the client.
Role of Nurses in Limited Ultrasound
Registered nurses may perform ultrasound exams
They must possess the body of knowledge necessary to assess the significance of
normal and abnormal findings.
They must complete an ultrasound course that adheres AWHONN guidelines.
They must have continual hands on ultrasound training with a professional
skilled in ultrasound until they are deemed competent. Competency will require
at least 50-75 supervised scans, maybe more. The supervising professional should
have a plan as to how to determine competency.
Prior to performing ultrasound exams the nurse's competency is evaluated by the
medical director or designee and a letter of competency from the medical
director is placed in the nurse's file. On going assessment of competency is to
occur.
The nurse performs only a limited ultrasound exam.
First Trimester
Using M-mode, fetal heart rate (FHR) or lack thereof is measured and documented.
The uterus is scanned in both the longitudinal and transverse planes. The
gestational sac or fetus is imaged and labeled.
The yolk sac, preferably with the fetus in the image is documented.
If multiple embryos are present, the fetal number is documented.
Second and Third Trimesters
Using M-mode, the fetal heart rate is measured and documented.
Documentation
Written ultrasound report as well as pictures will be reviewed and signed by the
medical director or designee. Pictures will also be given to the client.
Roles of Physician/Sonographer in Ultrasound
Licensed physicians, physician assistants, nurse practitioners and sonographers
must practice at the level of their training and at the standard of care in
their community. Therefore, performing a limited ultrasound may not be
appropriate for these practitioners. However, if the physician ordering the
ultrasound requests a limited scan, this can be done as long as the clinic's
adopted guidelines are followed.
First Trimester
Determine pregnancy location
Determine fetal number and gestational sac number
Record cardiac activity
Scan uterus, cervix, both adenexa for abnormalities
Gestational sac size
Crown-rump length
Second Trimester
The machine must be capable of providing the quality of information required in
a second trimester scan.
The physician/sonographer must have the time and skill to do a complete scan.
If center does not do second trimester scans, but a client's inaccurate dates
result in a determination of a second trimester pregnancy, then the operator
will show legs, arms, and beating heart. The ultrasound will be discontinued at
that point. If the client is still abortion-vulnerable, she is referred to
another ultrasound resource.
Documentation
A physician who is skilled in reading and/or performing obstetrical ultrasounds
will review all ultrasound exams.
Clients will be given pictures to document dating and fetal heart motion. Copies
of the scans obtained to fulfill the criteria of section C will be placed in the
chart.
"Excellence of Care: Standards for Medical Clinics" is available in its entirety
from Focus on the Family. You may call 1-800-A-FAMILY and ask for Item Code #
FX821