Standards Emergency Echo

Staffing and training.

1) All individuals who scan and report independently should be trained to their level of clinical practice (i.e. Focused Intensive Care Echo (FICE), Focused Echocardiography in Emergency Life Support (FEEL), BSE Level 1 or Level 2).

2) An Emergency Echocardiography Service Lead should be identified. This person should be BSE Level 1 or Level 2 accredited. This person will have responsibility for ensuring the ongoing training of staff, maintenance of equipment, and co-ordination of a formal out of hours Emergency Echocardiography Service rota (if this service is available). They will have time in their job plan for emergency echo.

3) If the Emergency Echo service lead is not a Cardiologist, alink-person from the host institution's Cardiology department should be identified. This will usually be either a Senior Echocardiographer or a Consultant Cardiologist.

4) Ideally, regional networks and electronic image transfer systems should be created to allow for prompt access to over-reading of scans by a BSE Level 2 accredited (or equivalent) individual when requested.

Requirements for equipment.

1) 90% of Emergency Echocardiograms should be performed within an hour of their request.

2) The appropriate minimum data-set of images should be stored electronically for each case (depending on the level of practice of the individual).

3) A structured report should be produced in a timely manner and stored in the patient records for each scan performed or verified by an accredited practitioner.

4) Unverified training images and reports should be stored for subsequent review, but not in the patient records.

5) Echo machines should be easily portable, less than 10 years old (ideally less than 5yrs old) and regularly serviced.

6) Echo machines should be stored in a secure location that is readily accessible at any time and geographically close to the site(s) where emergency echocardiograms are most likely to be performed.

7) Echo machines should be easily attachable to a network which allows for the uploading of images to the same archive that is used by the host institution's Cardiology department.

8) Reporting workstations should be readily available in areas where it is anticipated that emergency echocardiograms will be performed.

Requirements for Governance.

1) Every individual who participates in an Emergency Echocardiography Service should regularly attend a clinical governance forum, for example their host institution's Cardiology department echocardiography meeting. Ideally this should be job-planned.

2) There should be a process of quality assurance in place for the Emergency Echocardiography service. It is expected that departments will utilise the Echo Quality Framework to achieve this and achieve a minimum of amber in all areas.