Quick Navigation - What Study are you DOing?


Is It "Educational" or is it "Clinically-Indicated"?

Before a scan is performed, determine if this the study is an educational study or a clinically-indicated study. If you are unsure, discuss with the attending prior to starting the study.

An educational ultrasound examination:

  • Is done for provider education only
  • Requires patient verbal consent and the patient should verbalize understanding that the exam is for education only
  • Must have a confirmatory study (CT, US, MRI) performed or ordered prior to the exam
  • Will be reviewed with the confirmatory study
  • Will have a completed worksheet in QpathE, but this information will not transfer to the patient’s chart
  • No information about the educational study is discussed in the patient chart

A clinically-indicated ultrasound examination:

  • Is performed for medical decision making for that patient during their emergency department visit
  • Standard imaging consent is obtained
  • Needs to be documented in QpathE and signed by the attending. When signed, the report and images will transfer to the patient’s chart, under the Imaging tab.
  • The physician should discuss their examination as part of their medical decision making in the chart

Ultrasound Image Acquisition Requirements

Click above for more information on Bedside Aorta Ultrasound!

Measure Outer Wall to Outer Wall at each location (clip and still image recommended)

1.) Transverse image at Proximal, Mid, and Distal Aorta

2.) Saggital or Longitudinal image at Distal Aorta and Bifurcation

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Click above for more information on Bedside Renal Ultrasound!

Add Color Doppler to potential hydronephrosis to ensure it is not a vessel. Evaluate for ureteral jets if any hydronephrosis seen.

1.) Long and Short Axis View of Right and Left Kidney

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2.) Transverse and Saggital View of Bladder with Views of Ureteral Jets

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Click above for more information on Bedside RUQ Ultrasound!

Multiple images of each view is recommended.  Evaluate the gallbladder neck fully.  Use Color Doppler to ensure identification of CBD.


2.) Long Axis

1.) Short Axis

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3.) Common Bile Duct

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Click above for more information on Bedside Basic Cardiac Ultrasound!

Parasternal Long Axis (PSTL), Parasternal Short Axis (PSAX), Apical 4 Chamber (AP 4/5), Subxiphoid, and IVC Images

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Click above for more information on Bedside Early Pregnancy Ultrasound!

Transabdominal Views - Transverse and Sagittal Views of the Uterus

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Transvaginal Views - Transverse and Sagittal Views of the Uterus

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If Intrauterine Pregnancy Visualized, Document FHR and Crown Rump Length

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Click above for more information on FAST

3 Components to a FAST Exam (include each as clinically indicated)

1.) Abdomen

  • RUQ - include hepatorenal space, sub-diaphragmatic space, and inferior edge of the liver
  • LUQ -  include splenorenal space, sub-diaphragmatic space, left paracolic gutter
  • Pelvis - transverse and sagittal views
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2.) Cardiac

  • Obtain any one of the Parasternal Long Axis, Apical 4 Chamber, or Subxiphoid Views
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3.) Thoracic

  • Anterior Chest - Right and Left
  • Lateral Inferior Chest, Coronal View - Right and Left
    • Visualize Diaphragm and Spine.  These can be obtained concurrent with abdominal RUQ and LUQ views

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Obtain clips demonstrating compression of the vein. Another option is to utilize dual mode and obtain side-by-side still images of each site uncompressed and compressed.

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If evaluating only for pneumothorax bilateral anterior chest clips are sufficient. M-mode can also be utilized.

If evaluating only for pleural effusion bilateral lateral inferior chest views that demonstrate the diaphragm are sufficient.

If evaluating for parenchymal disease 10 zones should be assessed: Right and left anterior superior, anterior inferior, lateral superior, posterior inferior, lateral inferior.

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List of Acceptable Confirmatory Studies For Educational POC Ultrasound Examinations

**Any of these educational examinations can be performed with a credentialed faculty without obtaining confirmatory studies

Superficial

  • Consultative soft tissue ultrasound 
  • X-ray of the body region being examined
  • CT of the body region being examined
  • MRI of the body region being examined

Level 1 Cardiac

  • Consultative Echocardiogram
  • CT of the chest
  • MRI of the chest

Advanced Cardiac

  • Consultative Echocardiogram
  • CT of the chest
  • MRI of the chest

DVT

  • Consultative DVT ultrasound
  • MRI of the lower extremity
  • CT venogram of the lower extremity

Gallbladder

  • Consultative RUQ ultrasound 
  • CT of the abdomen
  • MRI of the abdomen

Abdominal

  • Consultative abdominal ultrasound
  • Abdominal CT
  • Abdominal MRI

Scrotal

  • Consultative scrotal ultrasound
  • CT of the scrotum/pelvis
  • MRI of the scrotum/pelvis

Non-pregnancy pelvic

  • Consultative pelvic ultrasound
  • MRI of the pelvis
  • CT of the pelvis

FAST

  • Consultative abdominal ultrasound 
  • CT of the abdomen
  • MRI of the abdomen

Aorta

  • Consultative abdominal ultrasound 
  • CT of the abdomen
  • MRI of the abdomen 
  • Aortic angiography

Renal

  • Consultative renal ultrasound
  • CT of the abdomen
  • MRI of the abdomen

Obstetric

  • Consultative Obstetric ultrasound 

Thoracic

  • Chest x-ray
  • CT of the chest
  • MRI of the chest

Musculoskeletal

  • X-ray of the body region being examined
  • CT of the body region being examined
  • MRI of the body region being examined

Ocular

  • CT of the orbits
  • MRI of the head/eye

Vascular

  • Vascular lab-performed consultative ultrasound
  • CT angiogram
  • Traditional angiography