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At
the summer meeting in July, the ICAEL Board of Directors made
revisions to the Standards, creating the new version
entitled 2007 ICAEL Standards. This article will
provide an overview of the key revisions. Please visit www.icael.org
to download and review the new Standards in their entirety.
Upon opening these documents online, you will find that the
edits made in conjunction with the release of this new version
appear as highlighted text. However, when the documents are
printed, the highlights will not appear in your permanent copy.
The 2007 ICAEL Standards are effective immediately.
PART I
Echocardiography Laboratory Operations
SECTION
1 - PERSONNEL AND SUPERVISION
The
definition of the Technical Director has been expanded and now
includes language related to Technical Directors that oversee
more than one laboratory. This change occurs in both the Adult
and Pediatric Operations Standards.
1.2
A qualified Technical Director(s) must be designated for the
facility. The Technical Director is generally a full time
position. If the Technical Director serves as Technical Director
in more than one laboratory, an appropriately credentialed
sonographer who is a member of the technical staff must be
present in the laboratory in the absence of the Technical
Director and assume the duties of the Technical Director.
SECTION 3 - EXAMINATION DATA ARCHIVING,
EXAMINATION REPORTS AND LABORATORY RECORDS
Related
to the videotape archiving, the sentence stating "The
location and method of measurements performed should also be
archived" is no longer a part of the Standards.
Specific
to digital storage, clarification is now provided related to
the number of cardiac cycles to be acquired to allow for adequate
review, "...generally one or more cycles are recommended".
PART II
Adult Transthoracic Echocardiographic Testing
SECTION
1 - INSTRUMENTATION
Under
1.1 Cardiac Ultrasound Systems, the section related to transducers
has been updated as follows:
1)
At least two imaging transducers, one of low frequency
(2-2.5 MHz) and one of high frequency (3.5 MHz or higher);
or a multi-frequency transducer which includes these frequencies.
A transducer dedicated to the performance of nonimaging continuous
wave Doppler must be available at each site.
SECTION
3 - ELEMENTS AND COMPONENTS OF EXAMINATION PERFORMANCE
The
guidelines related to the complete transthoracic echocardiogram
and specifically, the view of the suprasternal notch, have been
qualified and now state "when indicated".
Specific
to standard Doppler flow evaluations:
2)
For aortic stenosis,
the systolic velocity must be evaluated from multiple transducer
positions (e.g., apical, suprasternal and right parasternal).
This must include interrogation from multiple views with a
dedicated nonimaging continuous wave Doppler transducer (at
least one clear envelope must be obtained).
SECTION
4 - EXAMINATION INTERPRETATION
Guidelines
for report text are now further defined:
A)
Report text must include
comments on:
- Left
ventricle (size, global and regional function)
- Right
ventricle (size and global function)
- Right
atrium (size)
- Left
atrium (size)
- Mitral
valve (structure and function)
- Aortic
valve (structure and function)
- Tricuspid
valve (structure and function)
- Pulmonic
valve (structure and function)
- Pericardium
- Aorta
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