Diagnostic Medical Sonographer

Job Function 4: Implements protocols

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Prepares patient for exam by explaining the procedure, including preparing patient for what sensations to expect (such as cold gel, local anesthesia, and biopsy procedures)
Transfers patient to ultrasound table, positions patient properly, and applies gel
Applies principles of aseptic technique
Performs the examination or procedure
Explains to the patient each step of the procedure as it occurs and elicits the cooperation of the patient
Observes the screen and adjusts equipment settings as needed for optimal imaging
Troubleshoots technical issues while scanning for later notification, notifying supervisor and following chain of command for communicating equipment malfunction and repair needs
Adapts the protocol according to images obtained or changes in patient’s clinical status during the examination or procedure with orders of physician or other supervising health care professional
Monitors the patient’s clinical and comfort status and performs basic patient care tasks as needed
Activates emergency protocols, contacts appropriate personnel, and administers first aid or basic life support, including taking vital signs and performing CPR if needed
Notifies appropriate health care providers when immediate medical attention may be necessary, based on the examination or procedure images, findings, or results, or the patient’s condition
Adjusts console settings to optimize images following ALARA
Adjusts scanning technique as appropriate to optimize image quality and diagnostic information
Utilizes multiple patient positions to evaluate anatomy, as needed
Obtains Doppler velocities and measurements, as needed
Performs remote procedure protocols, as needed
Assists in collection and labeling of tissue and fluid specimens, as needed

Job Function 5: Evaluates images, findings, or results

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Performs examination measurements and calculations per protocol
Confirms that the procedure, as performed, complies with the applicable protocol
Evaluates images to determine if additional images will improve the procedure or treatment outcome
Evaluates images for technical quality
Identifies limitations in the examination or procedure, such as equipment failure or lack of patient preparation
Reviews all data for completeness and accuracy
Reviews and adheres to quality assurance processes and tools
Identifies and reports exceptions to the expected outcome
Notifies appropriate health care provider(s) of exam results, images, or patient condition, including potential abnormalities (including possible pathological conditions or abnormalities)
Determines whether to extend the exam and initiates additional techniques, procedures, or imaging, with physician or other supervising health care professional approval

Job Function 6: Implements safety and quality improvement programs and protocols, including quality of care standards and sonographer health and well-being standards

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Assumes responsibility for the safety of the patient throughout the sonographic examination, and assesses the patient’s physical, emotional, and mental status prior to discharge
Maintains a safe environment for patients and staff, minimizing potential hazards
Prepares safety or accident reports for adverse or sentinel events
Reports symptoms of abuse or neglect, according to facility protocols
Practices proper body mechanics and posture to avoid injuries, including WRMSDs
Maintains proper workflow to avoid WRMSDs, including the use of ergonomic scanners and proper design and set-up of the bed, machine, and workstation
Maintains proper workload to avoid WRMSDs, including limiting the length of examinations and having adequate breaks between examinations
Recognizes and reports signs and symptoms of WRMSDs and changes in health status or well-being
Carries out quality assurance protocols and quality improvement measures within the facility
Implements or participates in programs the facility offers to improve the health and well-being of sonographers, including the reduction of stress and WRMSDs

Job Function 7: Documents care

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Reviews examination images, reports examination results, and compiles preliminary findings
Determines which images to include in documentation, emphasizing differences between healthy and pathological areas, accuracy, conciseness, and completeness
Ensures correct annotation of images
Adheres to American College of Radiology (ACR) or American Institute of Ultrasound Medicine (AIUM) reporting guidelines, including demographics, clinical details, and findings summary to physician or other supervising health care professional
Documents adaptations of the facility’s protocol, including contraindications, insufficient patient preparation or inability or unwillingness to complete the examination procedure, or physical circumstances under which the examination or procedure was performed
Documents and reports any possible critical findings
Creates, transmits, and archives documentation following appropriate state and federal requirements
Archives digital images and associated data securely, such as through a Picture Archiving and Communication System (PACS)
Maintains patient privacy and confidentiality following privacy laws (including Health Insurance Portability and Accountability Act standards) and facility policies and procedures
Communicates test or assessment results to appropriate medical professionals
Provides a written or electronic sonographer’s impression, including images and findings, to the interpreting physician or supervising health care professional, with a verbal report if needed

Job Function 3: Analyzes and determines the protocol for the diagnostic examination or procedure

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Adapts the protocol according to the patient’s disease process or condition, any contraindications, or other factors such as insufficient patient preparation (in consultation with a preceptor)
Consults appropriate medical personnel to determine an action plan, as needed
In consultation with an advisor, adapts the protocol according to any physical environment where the examination or procedure must be performed (e.g., operating room, sonography laboratory, patient’s bedside, emergency room) to ensure patient safety and comfort and minimize risk of sonographer injury, including work-related musculoskeletal disorder (WRMSD)
Applies independent judgment to optimize patient safety and comfort, diagnostic quality, and efficient use of resources while achieving the objective of the procedure and following written supervising physician or facility protocols
Determines that all procedural requirements are in place to achieve a quality procedure
Determines the need for and selects supplies and accessory equipment (e.g., selects a proper transducer)
Determines the course of action for an emergent situation
Selects appropriate equipment settings and patient positions
Integrates medical history, previous studies, and current symptoms to determine the appropriate diagnostic protocol and customize the examination or procedure to the patient’s needs
Uses professional judgment to adapt the protocol or consult appropriate health care providers, when necessary, to optimize examination or procedure images, findings, or results
Verifies that the planned procedure applies elements of the As Low As Reasonably Achievable (ALARA) standard, including lowest output power, most efficient scan time, and the shortest dwell time (where appropriate), consistent with acquiring the required diagnostic images and related information
Follows facility protocol and consults with the physician or other supervising health care professional to determine if an intravenous ultrasound contrast agent or other pharmacologic agent may enhance image quality or obtain additional diagnostic information

Job Function 1: Assesses and evaluates patient’s past and present health status

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Determines if a translator is needed and arranges for one if necessary
Verifies patient identification using multiple indicators such as full name and date of birth
Verifies that the ordered examination or procedure corresponds to the patient’s clinical history and current presenting indications
Reviews patient medical history and supporting clinical information such as prior imaging
Evaluates any patient limitations that may affect the procedure, including insufficient patient preparation, risk of allergic reactions, or patient’s inability or unwillingness to undergo the examination or procedure, and responds as needed
Ensures that the sonography examination order is complete, contains relevant information, and that the prescribed procedure is compliant with clinical indication and protocol
Consults the facility’s policies and supervising physician or other referring health care provider on how to proceed if the ordered examination or procedure does not correlate with the patient’s clinical history and presentation
Verifies that the patient, or their representative, understands and provides consent for the diagnostic sonographic examination or procedure
Complies with privacy and confidentiality standards and supervising physician or facility protocols
Verifies the patient’s pregnancy status, if applicable

Job Function 2: Communicates with and educates the patient

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Communicates explanations and instructions to the patient or their representative in a manner that is clear and effective for the patient
Exercises cultural sensitivity in communications with patients and families
Educates the patient about procedures and associated biological effects
Responds to questions or concerns from the patient or their representative (without hinting at diagnoses or suggesting outcomes)
Confirms examination preparation requirements such as fasting or bladder filling
Monitors the patient’s need for information and reassurance throughout the procedure and provides information within the limits of their role
Communicates authorized information from other health care providers to the patient or their representative, as directed
Refers specific diagnostic, treatment, or prognosis questions from the patient (or their representative) to the physician or other supervising health care professional, except as authorized by written facility policies and procedures

Job Function 8: Cleans and maintains equipment

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Cleans medical equipment, including low-level and high-level disinfection techniques
Assesses and maintains the integrity of medical supplies, properly disposing of them when indicated
Maintains inventory of medical supplies or equipment and identifies needs for ordering medical supplies or equipment
Submits maintenance requests for performing repairs as necessary
Confirms that equipment performance, maintenance, and operation comply with the manufacturer’s specifications
Conducts or reports need for preventive maintenance for ultrasound equipment
Cleans and prepares exam room and ultrasound equipment to conduct sonography examinations following protocols for infectious disease, sterilization as indicated, and patient safety

Job Function 9: Performs facility and administrative duties

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Assists with the education and training of sonography students and physician residents
Notifies supervisor and follows chain of command for communicating equipment malfunction and repair needs
Assists with the daily operation of the sonography facility
Maintains awareness of unauthorized access to controlled area
Coordinates work with physicians or other health care team members, including providing assistance during invasive procedures
Supervises other patient care personnel as needed
Performs clerical duties, such as scheduling exams or special procedures, maintaining medical facility records, or archiving computer images
Participates in maintenance of facility reports, database records, and logs

Job Function 10: Participates in professional development, including self-assessment standards, education standards, collaboration standards, and ethical standards

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Obtains and maintains professional certification/credentialing and state license, if required, in areas of clinical practice
Trains in new developments, technologies, and trends in relevant areas of clinical practice
Shares knowledge and expertise with colleagues, students, and members of the health care team
Adheres to accepted professional ethical standards and maintain professional accountability
Complies with federal and state regulations, accreditation standards, and written supervising physician or facility policies
Refrains from performing procedures outside of the scope of practice of sonography and authorized health care procedures, education, training, or research
Supports patient rights and acts as a patient advocate
Communicates effectively with members of the health care team regarding patient welfare while maintaining patient privacy in written, digital, and verbal communication
Promotes a collaborative atmosphere with members of the health care team
Upholds ethical standards for patient care at all times, including respecting patients’ rights and the privacy of medical information, and providing patient care with kindness, compassion, dignity, and respect for all
Performs only sonographic examinations that are appropriately authorized and procedures for which one is trained and competent

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