Perform, interpret and report on ultrasound examinations

This standard covers performing, interpreting and reporting on ultrasound images of anatomical structures. Imaging may be undertaken as part of a screening, diagnostic or monitoring process. Key people are those involved in the individual's care and others involved in provision of services, including chaperones. Users of this standard will need to ensure that practice reflects up to date information

1. apply standard precautions for infection prevention and control,

   and other appropriate health and safety measures

   2. ensure all necessary preparations have been made by the

   individual and staff before starting the procedure

   3. check and prepare the equipment required for the examination

   4. ensure the environment is conducive to maintaining the privacy

   and dignity of the individual

   5. check the identification and clinical history details before

   commencing the procedure in accordance with local policies and

   procedures

   6. introduce yourself and other members of staff present during the

   examination

   7. review any previous relevant imaging where available

   8. enter the identification details of the individual into the ultrasound

   machine or, if previously entered, check for accuracy

   9. obtain valid consent for the procedure in accordance with national

   and local guidelines

   10. respect the individuals privacy, dignity, beliefs and decisions

   11. confirm the appropriateness of key people before the examination

   in accordance with local guidelines

   12. communicate with the individual / key people to facilitate their

   understanding of and co-operation with the examination

   13. establish the individuals capacity to understand the procedure

   with the help of key people if necessary

   14. clearly explain the procedure and possible outcomes, including

   risk, benefits and limitations

   15. check for any contraindications for the proposed procedure and

   take appropriate action in response to identified risks

   16. ensure the individual is in an appropriate and comfortable position

   for the examination, ensuring clothing is suitably adjusted to

   facilitate the examination

   17. select and prepare the appropriate imaging technique, transducer

   and initial scanning parameters for the individual and the site

   under examination

   18. apply sufficient acoustic coupling gel to the area to be examined

   to ensure optimal sound transmission

   19. make adjustments to the equipment controls to optimise the

   image quality and recognise the appearance of ultrasound

   artefacts

   20. ensure power levels and insonation time are kept to a minimum in

   accordance with national and international safety guidelines

   21. acquire and interpret appropriate ultrasound images and produce

   a report in accordance with your scope of practice and in-line with

   national and local guidelines and protocols

   22. observe and be aware of the individuals condition and well-being

   at all times and take appropriate action in response to any signs

   of discomfort and/or distress

   23. take appropriate steps to minimise the risk of work-related

   disorders

   24. maintain communication with the individual / key people

   throughout the procedure

   25. record images with appropriate annotation and measurements

   according to national and local guidelines and protocols

   26. extend the procedure as appropriate to confirm or supplement any

   initial findings

   27. seek advice from appropriate others where you observe

   unexpected appearances or unusual findings that are outside your

   area of personal competence

   28. provide the individual with information relating to the procedure

   and aftercare where necessary

   29. explain the process for obtaining results

   30. advise a referral to the appropriate person if an abnormality is

   observed which is likely to require further investigation or

   treatment, following national and local guidelines and protocols

   31. record, collate and prepare appropriate information,

   documentation and images for transfer or storage according to

   local protocols

   32. verify that the images have arrived/been stored according to local

   protocols

1. legal, organisational and policy requirements relevant to your role,

   the role of others in your organisation and the activities being

   carried out

   2. the relevant national and local standards, guidelines, policies and

   procedures that are available and how and when they should be

   accessed

   3. the importance of respecting individuals culture, privacy, dignity,

   wishes, beliefs and decisions and how to do so

   4. the limitations of your own knowledge and experience and the

   importance of operating within your scope of practice

   5. preparation of the environment and equipment for ultrasound

   examinations

   6. local policy and protocol for arranging and working with a

   chaperone

   7. the physical processes involved in the production of an ultrasound

   image

   8. the biological effects and potential risks associated with the use of

   ultrasound

   9. the principles and applied knowledge of the Doppler effect and its

   clinical application in imaging and diagnosis

   10. artefacts on images - their causes, value, limitations and

   minimisation strategies

   11. the effect of sound propagation through different tissues

   12. techniques to optimise the ultrasound image including position

   and preparation of the individual

   13. the safe operation of ultrasound equipment

   14. the potential for work-related disorders and how to minimise the

   risk

   15. the importance of timely equipment fault recognition and local

   procedures for reporting these

   16. image capture and recording devices

   17. equipment age and capabilities, limitations and routine

   maintenance, including the quality control processes required by

   the operator

   18. the function, specification and performance characteristics of

   ultrasound equipment and transducers

   19. the clinical conditions appropriate for ultrasound examinations and

   the implications of other disease processes relevant to the area of

   study

   20. the clinical justification of the examination request and an

   understanding of limitations

   21. the contraindications associated with each investigation and the

   implications of proceeding with due consideration of related risks

   22. the clinical implications of any allergy relevant to the examination

   23. the importance of obtaining valid consent in line with national and

   local guidelines

   24. methods of communicating difficult and complex information to

   individuals and key people

   25. the importance of providing individuals and key people with

   opportunities to ask questions and increase their understanding

   26. the information that should be given to individuals before, during

   and on completion of the examination

   27. how to adapt communication styles, ask questions, and listen

   carefully in ways which are appropriate for the needs of the

   individual

   28. normal anatomy and physiology, normal variants and anatomical

   relationships demonstrable by ultrasound including knowledge of

   normal measurements and predisposing factors of the individual

   29. how to acquire the best possible diagnostic images for a range of

   type and size of individual

   30. recognition of abnormal anatomy and physiology demonstrable by

   ultrasound and the significance of such abnormality

   31. the pathological processes and their appearance on ultrasound,

   relevant to the examination undertaken

   32. manifestations of an individuals physical and emotional status

   33. the impact of equipment controls on image quality and production,

   and safety indices

   34. local procedures pertaining to the examination report

   35. report writing techniques including medical terminology and

   standard abbreviations relevant to the examination

   36. alternative imaging examinations, diagnostic and interventional

   techniques, and other relevant investigations

   37. referral pathways, follow-up procedures and support resources for

   the individual

   38. procedures relating to recording, collating and preparing

   appropriate information, documentation and images for transfer or

   storage according to local protocols

   39. how to keep full, accurate and clear records in line with

   organisational procedures

This standard links with the following dimension within the NHS

Knowledge and Skills Framework (October 2004):

Dimension: HWB6 Assessment and treatment planning