Proper
ultrasound instrument operation is critical in obtaining diagnostic images. The
operator must be able to properly display cardiac and/or vascular structures
and blood flow in each of the imaging views. A cardiac sonographer must
demonstrate proficiency in the performance of two-dimensional, M-mode, and
Doppler such as pulsed wave, continuous wave and color flow echocardiographic
diagnostic procedures.
Visualization
of all cardiac chambers, valves, and vessels, with appropriate structural and
blood flow measurements, should be provided using a standardized protocol. Abnormal
echocardiographic and Doppler velocities that are indicative of cardiovascular pathophysiology
must be accurately documented.
There are
multiple types of specialty practices in echocardiography, including adult transthoracic,
pediatric transthoracic, fetal, transesophageal, exercise and pharmacologic stress
examinations. The Intersocietal Commission for the Accreditation of Echocardiography
Laboratories (ICAEL) and the ASE has established guidelines and protocols for
each of these practice areas which should be followed.
In
addition, in light of the increasing use of echocardiography contrast agents, a
cardiac sonographer who performs echocardiograms in a laboratory that uses contrast
agents should be familiar with the use, potential side effects, and indications
for such agents, as well as any special protocols required by the institution.
If a cardiac sonographer participates in the performance of invasive procedures
such as intraoperative and echo-guided interventions or performs new
technologies, such as three-dimensional echocardiography, the sonographer must
demonstrate knowledge and competency in these additional specialty areas.
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