Guidelines For Professional Ultrasound Society and College of Radiographers and British Medical Ultrasound Society Revision 3, December 2018 SCoR/BMUS Guidelines for Professional Ultrasound Practice. Revision 3, December 2018 Minor amendments, March 2019. SOCIETY AND COLLEGE OF RADIOGRAPHERS AND BRITISH MEDICAL ULTRASOUND SOCIETY GUIDELINES FOR PROFESSIONAL ULTRASOUND PRACTICE DECEMBER 2015 Revision 3, December 2018. Minor amendments, March 2019 Contents Acknowledgements ...................................................................................................................................................... 4 Foreword ...................................................................................................................................................................... 6 December 2015 edition ........................................................................................................................................ 6 Revision 1, December 2016 .................................................................................................................................. 6 Revision 2, December 2017 .................................................................................................................................. 7 Revision 3, December 2018. Minor post publication amends March 2019 ....................................................... 7 SECTION 1: GENERAL INFORMATION ......................................................................................................................... 11 1.1 EXPLANATION OF THE PROFESSIONAL TITLE ‘SONOGRAPHER’ ................................................................. 11 1.2 REGISTRATION FOR SONOGRAPHERS......................................................................................................... 12 1.3 PROFESSIONAL INDEMNITY ........................................................................................................................ 13 1.4 PROFESSION vs TOOL .................................................................................................................................. 14 1.5 SAFETY OF MEDICAL ULTRASOUND ............................................................................................................ 14 1.6 MEDICO-LEGAL ISSUES ............................................................................................................................... 16 1.7 TRANSDUCER AND EQUIPMENT CLEANING AND DISINFECTION ............................................................... 17 1.8 SCREENING EXAMINATIONS USING ULTRASOUND .................................................................................... 19 1.9 ERGONOMIC PRACTICE INCLUDING MANAGING THE HIGH BMI PATIENT ................................................ 21 1.10 INTIMATE EXAMINATIONS AND CHAPERONES .......................................................................................... 23 1.11 EXAMINATION TIMES ................................................................................................................................. 24 1.12 THE 6 C’s, PATIENT IDENTIFICATION, COMMUNICATION AND CONSENT ................................................. 25 1.13 CLINICAL GOVERNANCE .............................................................................................................................. 27 1.14 E-LEARNING FOR HEALTHCARE .................................................................................................................. 29 1.15 IMAGING SERVICES ACCREDITATION SCHEME (ISAS) ................................................................................ 29 1.16 ULTRASOUND EQUIPMENT AND QUALITY ASSURANCE TESTING .............................................................. 30 1.17 RAISING CONCERNS; SAFEGUARDING; STATUTORY REQUIREMENTS FOR REPORTING FEMALE GENITAL MUTILATION (FGM), DUTY OF CANDOUR .............................................................................................................. 31 1.17.1 Raising concerns ...................................................................................................................................... 31 1.17.2 Safeguarding ............................................................................................................................................ 31 1.17.3 Female Genital Mutilation (FGM) - statutory requirements of practitioners ......................................... 32 1 SCoR/BMUS Guidelines for Professional Ultrasound Practice. Revision 3, December 2018 Minor amendments, March 2019. 1.17.4 Duty of Candour....................................................................................................................................... 32 1.18 CONTINUING PROFESSIONAL DEVELOPMENT ........................................................................................... 33 1.19 CODES OF PROFESSIONAL CONDUCT FOR SONOGRAPHERS ..................................................................... 34 1.20 CONSCIENTIOUS OBJECTION ...................................................................................................................... 36 1.21 INDEPENDENT PRACTICE ............................................................................................................................ 36 SECTION 2: THE ULTRASOUND EXAMINATION .......................................................................................................... 39 2.1 OVERVIEW OF ULTRASOUND EXAMINATION PROCEDURES ...................................................................... 39 2.2 OBSTETRIC, VASCULAR, ECHOCARDIOGRAPHY AND BREAST EXAMINATIONS............................................ 39 2.3 NICE AND OTHER GUIDELINES .................................................................................................................... 40 2.4 VETTING OF ULTRASOUND REQUESTS ....................................................................................................... 41 2.5 JUSTIFICATION OF ULTRASOUND REQUESTS ............................................................................................. 41 2.6 RECOMMENDATIONS FOR THE PRODUCTION OF AN ULTRASOUND REPORT ........................................... 43 2.7 GYNAECOLOGICAL ULTRASOUND EXAMINATIONS .................................................................................... 50 2.7.1 General scanning principles ...................................................................................................................... 50 2.7.2 Structures to examine and evaluate ......................................................................................................... 51 2.7.3 Pathology .................................................................................................................................................. 52 2.7.4 Extending the examination ....................................................................................................................... 57 2.7.5 Pelvic ultrasound reporting ...................................................................................................................... 57 2.7.6 Reporting Examples .................................................................................................................................. 57 2.8 ABDOMINAL ULTRASOUND EXAMINATIONS ............................................................................................. 59 2.8.1 General principles ............................................................................................................................... 59 2.8.2 Ultrasound examination of the liver ................................................................................................... 63 2.8.3 Ultrasound examination of the gallbladder and biliary tree .............................................................. 65 2.8.4 Transabdominal ultrasound examination of the pancreas ................................................................ 66 2.8.5 Ultrasound examination of the spleen ............................................................................................... 68 2.8.6 Ultrasound examination of the abdominal aorta ............................................................................... 71 2.8.7 Ultrasound examination of the bowel ................................................................................................ 72 2.9 URO-GENITAL SYSTEM INCLUDING TESTES AND SCROTUM ...................................................................... 76 2.9.1 Ultrasound examination of the kidneys ............................................................................................. 76 2.9.2 Ultrasound examination of the testes and scrotum ........................................................................... 79 2.10 ULTRASOUND EXAMINATION OF THE ADULT HEAD AND NECK ................................................................ 82 2.11 PAEDIATRIC ULTRASOUND EXAMINATIONS ............................................................................................... 86 2.11.1 Paediatric liver and biliary system ...................................................................................................... 86 2.11.2 Paediatric Urinary system ................................................................................................................... 90 2.11.3 Paediatric gastro-intestinal tract ........................................................................................................ 91 2.11.4 Neonatal hip ......................................................................................................................................