ATEE Study/Report Checklist s1

ATEE Study/Report Checklist ATEE Cases

Does the study demonstrate optimization of equipment and display settings (i.e., depth zoom etc.)?

Yes No

Does the study include all Echocardiography Standards views? (List below)

Gastric short axis and long axis views Multiple imaging planes of the atrial septum and Standard 2- and 4-chamber views foramen ovale with appropriate Doppler Short and long axis views of the aortic valve Imaging of at least one left and one right with appropriate Doppler pulmonary vein with appropriate Doppler, when Multiple imaging planes of the mitral valve with mitral regurgitation is present appropriate Doppler Short axis views of the ascending, descending Multiple imaging planes of the tricuspid valve and transverse arch of the aorta with appropriate Doppler Long axis views of the main pulmonary artery Longitudinal view of the pulmonic valve with and proximal portions of the right and left appropriate Doppler pulmonary arteries Multiple imaging planes of the right atrium, left Images of the proximal inferior and superior atrium and left atrial appendage with appropriate vena cava Doppler Imaging of the pericardial space and pericardium

Does the study demonstrate proper Doppler technique?

Yes No

Does the study adequately demonstrate cardiac chamber sizes?

Yes No

Does the study demonstrate adequate evaluation of left ventricular chamber anatomy function?

Yes No

Does the study demonstrate valvular function with the use of spectral and color flow Doppler?

Yes No

Does the study demonstrate the atrial septum and its integrity (including the use of contrast in source of embolus cases)?

Yes No

Evaluating ATEE Studies & Reports Checklist 1 (Updated 4-2017) ATEE Reports

Is the report standardized in format with the other submitted final reports?

Yes No

Does the report text include comments on medications used, complications and all components of the procedure?

Yes No

Is the following required demographic information present on the final report? (List below)

The date of the study The primary indication for the study The name and/or identifier of the facility The name of the performing physician The name and/or identifier of the patient The name of the ordering physician and/or The date of birth and/or age of the patient identifier Gender of the patient Blood pressure Height and weight

Does the final report include all required comments for the following cardiac structures and valves (list below)?

Left Ventricle Mitral Valve Right Ventricle Aortic Valve Right Atrium Tricuspid Valve Left Atrium Pulmonic Valve Left Atrial Appendage Pericardium Interatrial Septum Aorta

Is there a summary of pertinent findings?

Yes No

Does the typewritten report include any handwritten comments?

Yes No

Is the report free of typographical errors?

Yes No

Is the printed name of the interpreting physician on the report?

Yes No

Was the final report reviewed, signed and dated manually or electronically by the interpreting physician?

Yes No

Was the final report verified (by the interpreting physician) and signed within 48 hours after interpretation?

Yes No

Comments:

Evaluating ATEE Studies & Reports Checklist 2 (Updated 4-2017)