CEUS Position Statement on Advanced Applications

It is the unwavering position of CEUS that Core Independent Practitioner status is the minimum necessary for safe and efficient emergency ultrasound practice. This provides a structure wherein physicians with various levels of prior experience and training in emergency ultrasound can have their skills objectively assessed. 

The arrival of advanced applications in emergency ultrasound practice is a natural step in the evolution of this modality. It is the position of the CEUS that the use of these advanced applications should be encouraged. Ultrasound is now an essential part of the armamentarium of any physician working in emergency departments or any other critical care setting. It is clear, however, that advanced applications require greater manual dexterity and image recognition skills than the basic indications.

CEUS therefore strongly recommends that all physicians wishing to use ultrasound for advanced applications first complete the CEUS Core Independent Practitioner training program. Any group wishing to introduce advanced applications into their practice should follow the same high standards of the CEUS process, even if this is done in an informal manner. After completion of an advanced applications course, this would include:

  1. Execution of scans under supervision
  2. Confirmation of image recognition skills through positive image review exercises
  3. Ongoing QA/QC by a local leader thoroughly versed in the advanced applications being used in their center.

It should be noted that the learning curves for the various advanced applications are quite variable. Pursuing these applications only after obtaining CEUS IP status ensures that the trainee already has well-developed image-recognition skills and a clear sense of the effort required to achieve a high standard of image generation.

For those who wish to obtain a more formal certification from CEUS for performing advanced applications, the Advanced Applications Certification process is being developed and will be finalized soon. 

Some indications for Advanced POCUS:

  • Shock
  • Trauma
  • Cardiac function
  • Dyspnea
  • Needle guidance for lines, aspiration, injection, foreign body removal
  • Deep venous thrombosis
  • Pleural effusion
  • Biliary
  • Renal/Bladder
  • Soft tissue
  • Joint assessment
  • Ocular
  • Nerve Blocks
  • Fracture/fracture reduction