For clinicians who wish to be recognized for obtaining skills in advanced POCUS applications, CEUS has developed Expanded Application certificates. As there are a wide variety of applications now available, candidates may choose to obtain IP status in one or more of the following pathways or general categories of skills:
1. Resuscitative Path: PSL, PSS, A4C cardiac views, pulmonary, IVC
2. Diagnostic Path: Gallbladder, Renal, Bladder, DVT, ocular
3. Musculoskeletal Stream: Fracture diagnosis and reduction, joint assessment, joint reduction, soft tissue injury, abscess, tendon rupture, etc.
Each stream requires completion of a CEUS recognized course that covers the particular applications. This is followed by a minimum number of scans performed on live models or patients directly supervised by a instructor certified in that path. In addition the candidate must obtain further scans and record them for review with an instructor. It is expected that at least one positive finding for each application be observed during the apprenticeship period. If the trainee does not encounter a positive, a video library demonstrating the positive finding must be reviewed.
Once all of the scanning requirements are complete, the trainee may challenge the credentialing exams for the desired application stream. This includes a written exam involving multiple choice questions with pass score of 85%. This is followed by a visual exam conducted one-on-one with an instructor on a computer, with a pass score of 85%. Finally, an observed practical exam is conducted with an instructor that involves demonstrating how to use an ultrasound machine, how to perform the required scans, the ability to recognize critical ultrasound anatomy, and how to problem solve the difficult scan.