CHHS15/076

Canberra Hospital and Health ServicesClinical ProcedureUltrasounds and Echocardiograms in the Department of Neonatology - NeonatesContents

Contents....................................................................................................................................1

Purpose.....................................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Ultrasounds............................................................................................................2

Section 2 – Echocardiograms (Clinician performed Cardiac Ultrasound)..................................3

Implementation........................................................................................................................ 3

Related Policies, Procedures, Guidelines and Legislation.........................................................3

References................................................................................................................................ 4

Definition of Terms...................................................................................................................4

Search Terms............................................................................................................................ 4

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS15/076

Purpose

This clinical procedure has been developed for Medical Staff undertaking cranial and cardiac ultrasounds in the Department of Neonatology

Scope

This document pertains to infants and neonates in the Department of Neonatology This document applies to:

Senior Medical Officers Junior Medical Officers under supervision

This procedure must be undertaken under supervision for those performing this procedure for the first time

Section 1 – Ultrasounds

Hand hygiene as per Hand Hygiene SOP CED No. 11-50

Procedure Ultrasounds and echocardiograms are performed in the Department of Neonatology by medical staff of the Department of Neonatology, staff from the Radiology/ Ultrasound Department or Cardiologists.

Neonatologists or Neonatologists-in-training are to follow these processes when doing cranial ultrasounds: 1. Radiologists must review and report on all ultrasounds undertaken by their Department. 2. If medical staff of the Department of Neonatology detect an abnormal finding on

ultrasound, this should be confirmed by ultrasound performed by the Radiology/Ultrasound department

3. If an ultrasound done by medical staff of the Department of Neonatology shows severely abnormal findings (Intraventricular Haemorrhage grade III or IV or tumour) confirmation of this finding by the ultrasound department by a recognised specialist must be sought within 24 hours

4. If an ultrasound has been found normal this must be verified by a routine ultrasound performed by the ultrasound department during the week

5. Documentation of findings and reporting is recorded in the patients clinical record 6. Scans performed as part of research need separate consent and ethics approval

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Section 2 – Echocardiograms (Clinician performed Cardiac Ultrasound)

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS15/076

Hand hygiene as per Hand Hygiene SOP CED No. 11-50

Neonatologists or Neonatologists-in-training are to follow these processes when doing clinician performed cardiac ultrasounds:1. Structural echocardiogram (assessing anatomy) should be done by a cardiologist where

possible. 2. Neonatal clinicians perform cardiac ultrasounds to assess cardiac function, pulmonary

pressures and Patent Ductus Arteriosus (PDA) size. They should restrict their scans to inpatients who are preterm or have clinical symptoms of cardiovascular disease instability

3. If there are any concerns regarding structural heart disease then the neonatal clinician should liaise closely with a cardiologist or paediatric cardiologist

4. Echocardiograms must be recorded on the machine and downloaded to the Xcelera for storage, review and audit

5. For all clinical scans documentation of findings and reporting is recorded in the patients’ clinical record and a formal report is generated on Xcelera within seven days. All scans performed by clinicians in training need to be reviewed by a neonatologist with CPU accreditation

6. Scans performed as part of research need separate consent and ethics approval

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Implementation

This is an updated procedure and current medical staff will be updated on the procedure.The procedure will be part of orientation of new medical staff.

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Related Policies, Procedures, Guidelines and Legislation

Hand Hygiene SOP CED No. 11-50

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS15/076

References

El-Khuffash, A, McNamara, P 2011, Neonatologist-performed functional echocardiography in the neonatal intensive care unit, Seminars in Fetal & Neonatal Medicine, no:16, pp. 50-60

Kluckow, M 2014, Use of ultrasound in the haemodynamic assessmentof the sick neonate, Archives of Diseases in Childhood-Fetal and Neonatal Editionno. 99,pp. F332–337.

Mertens, L, Seri, I, Marek, J, Arlettaz, R, Barker, P, McNamara, P, Moon-Grady, A, Coon, P, Noori, S, Simpson, J & Lai, W 2011,Targeted neonatal echocardiography in the neonatalintensive care unit: Practice guidelines and recommendations for training, Journal of the American Society of Echocardiography, vol.24, pp. 1057-78.

Wezel-Meijler, G, Steggerda, S and Leijser, L 2010, Cranial ultrasonography in neonates: Role and Limitations, Seminars in Perinatology, vol. 34, pp. :28-38.

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Definition of Terms

CPU Clinician Performed UltrasoundThe certificate in CPU is a credential awarded by the Australian Society for Ultrasound in Medicine Council to medical practitioners who are not imaging specialists but who may use ultrasound as a diagnostic tool at the point of care. The CCPU represents a level of proficiency in image acquisition, optimisation and ultrasound skills relevant to the specialty medical area.

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Search Terms

Neonatal Intensive CareNeonateUltrasoundEchocardiogram

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Disclaimer: This document has been developed by ACT Health, Department of Neonatal, Division for Women, Youth and Children specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register