But I think the point of the original post is that ultrasound practice may 
well need to be carefully monitored in the broadest sense but such 
"policing" should be done by our own specialty rather than by another 
specialty. After all, we do not seek orthopaedic approval or training before 
reducing Colles fractures or shoulder dislocations, nor cardiology approval 
or training before thrombolysing MIs etc.

AF

----- Original Message ----- 
From: "JAMES CAMERON" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, January 30, 2006 6:52 AM
Subject: Re: Ultrasound in the ED - RCR guidelines


> The guidance for ultrasound sounds very sensible, with a course, evidence 
> of maintaining awareness of the literature, performing at least 50 per 
> year, regular audit, a logbook, a pictorial record and an ultrasound 
> mentor in the department of radiology.
>
>  Perhaps we should apply similar criteria to practitioners planning to 
> perform reduction of shoulders, or management of the airway.
>
>  Why is ultrasound unique in this regard?
>
>  James Cameron
>  SpR UCH.
>
>
>
>
> Brendan Conway <[log in to unmask]> wrote:
>  Thankfully good relations have been established between RCR and CEM. My 
> understanding
> is that the then Faculty was part of the process of drawing up the 
> guidelines,
> and so they resemble those not of american radiologists but of ACEP and 
> ACEM.
> The guidelines were approved by Faculty, and say so. There is no treasure
> greater than compliant radiologists when it comes to the propagation of 
> ultrasound
> technology. BTW, CEM is due to issue new US guidance this year.
>>-- Original Message --
>>Date: Sat, 28 Jan 2006 19:05:41 -0000
>>Reply-To: Accident and Emergency Academic List
>>From: Dr Mandar Marathe
>>Subject: Re: Ultrasound in the ED - RCR guidelines
>>To: [log in to unmask]
>>
>>
>>Emergency Department bedside diagnostic ultrasound in the UK is far behind
>>the USA, where it is estimated that 70% of EPs routinely use it (data from
>>2003).
>>
>>During the development of ED ultrasound in the USA, radiologists were
>>concerned they would lose revenue if EPs started to use ultrasound, and
> this
>>was largely the basis of their resistance towards EPs touching ultrasound
>>machines, let alone be trained in their use.
>>
>>Various conflicts and turf wars followed, and this reached a climax when
>>their RCR-equivalent issued a document which set criteria for competancy
>>for
>>EPs (e.g. the number of scans needed to demonstrate competancy) which even
>>the average radiologist would struggle to meet.
>>
>>This document was flatly rejected and ignored by the ACEP which proceeded
>>to
>>create their own guidelines:
>>
>>http://www.acep.org/NR/rdonlyres/8024079E-28E8-4875-93E6-6867EA705A2A/0/ultrasound_guidelines.pdf
>>
>>
>>Last year I had the good fortune to meet some of the EPs involved at the
>>highest levels of managing ultrasound development in the USA. The current
>>thinking amongst American EPs is that their equivalent of the RCR should
>>have no influence or control or say over ultrasound use in the ED.
>>
>>They have found ED ultrasound to be too valuable a tool to be controlled
>>or
>>monopolised by their RCR.
>>
>>
>>
>>----- Original Message -----
>>From: "Brendan Conway"
>
>>To:
>>Sent: Saturday, January 28, 2006 5:42 PM
>>Subject: Ultrasound in the ED - RCR guidelines
>>
>>
>>I expect not everyone is aware (since I only found out recently by chance
>>myself) that the Royal College of Radiologists issued detailed guidelines
>>last year on the use of ultrasound in Medical and Surgical Specialties.
> This
>>includes a detailed section on the use of focused ultrasound in the
>>Emergency
>>Department. These include the recognition that we can train other EPs with
>>a lesser level of knowledge than our own, and states that we need to keep
>>a logbook. Is anyone on the list implementing these guidelines at present?
>>
>>Link is at http://www.rcr.ac.uk/docs/radiology/pdf/ultrasound.pdf
>
>
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