Overview Of The Profession

Sonography is a non-invasive medical procedure that uses the echoes of high-frequency sound waves to construct an image of internal organs or body structures. In sonography, a transmitting device (transducer) sends out high-frequency ultrasound waves (containing no radiation) which bounce off the surfaces of the object they hit. The reflected sound forms an echo which is visualized on the screen.

There are several areas of specialization in the field of sonography, including:

• Abdomen (AB) - evaluation of all the soft tissues, blood vessels and organs of the abdominal cavities (for example: liver, spleen, urinary tract and pancreas), and small parts/superficial structures (for example: thyroid and scrotum).
• Breast (BR) - evaluation of normal breast as well as breast abnormalities that are found with screening or diagnostic mammography
• Obstetrics (OB)/Gynecology - evaluation of the female reproductive system and fetal development during the 1st, 2nd and 3rd trimester.
  
• Vascular Technology (VT) - evaluation and analysis of the hemodynamics (blood flow) of peripheral vessels, abdominal blood vessels, intracranial and extracranial vessels.

A diagnostic medical sonographer is a highly-skilled professional who uses specialized equipment to create images of structures inside the human body. As an occupational prerequisite, the diagnostic medical sonographer must be educationally prepared and clinically competent. Demonstration and maintenance of competency through certification by a nationally recognized credentialing organization is the standard of practice in Sonography. 

The diagnostic medical sonographer functions as delegated agent of the physician and does not practice independently. Diagnostic medical sonographers are committed to enhanced patient care and continuous quality improvement that increases knowledge and technical competence. Diagnostic medical sonographers use independent, professional and ethical judgment and clinical thinking to perform diagnostic procedures safely. 

The professional responsibilities of a diagnostic medical sonographer include, but are not limited to:

• Obtains, reviews, and integrates pertinent patient history and supporting clinical data to facilitate optimum diagnostic results
• Performs appropriate procedures and records anatomic, pathologic, and/or physiologic data for interpretation by a physician.
• Records, analyzes and processes diagnostic data and other pertinent observations made during the procedure for presentation to the interpreting physician
• Exercises discretion and judgment in the performance of sonographic and/or related diagnostic services.
• Demonstrates appropriate communication skills with patients and colleagues
• Acts in a professional and ethical manner
• Facilitates communication and education to elicit patient cooperation and understanding of expectations and responds to questions regarding the sonographic examination.

The above information was obtained from the Commission on Accreditation of Allied Health Education Program (CAAHEP), Standards and Guidelines for an Accredited Educational Program for the Diagnostic Medical Sonographer,2021.

Essential Skills & Abilities

To practice sonography, sonographers must possess the following skills and abilities:

1. Motor Skills

• Sit, stand or walk for extended periods
• Ability to demonstrate hand-eye coordination for scanning using fine and gross motor skills
• Perform physically strenuous tasks including transport, lift, move, and transfer patients from bed to wheelchair or stretcher and  then from wheelchair or stretcher back to bed. 
• Possess the ability to carry equipment and supplies which includes carrying, benign, kneeling, twisting, stooping, lifting crouching, pushing, pulling, reaching (including overhead)
• Ambulate independently and rise from a seated position without assistance
• Administer CPR independently
• Perform hand and upper extremity fine motor skills to include repetitive motions and sustained positions for extended periods of time 
• Fine motor skills with the wrists, hands and fingers,  such as hold, grasp and turn objects 
• Type on equipment while holding transducer and scanning with opposite hand

2. Sensory Skills

• Visual ability (Corrected as needed) for patient care to include but not limited to the following: recognize and interpret facial expressions, body language, normal and abnormal movement patterns
• Visual ability (Corrected as needed) to focus for equipment use for extended periods
  • Depth perception
  • Peripheral vision
  • Distinguish subtle shades of gray and color changes
  • Subtle differences of shapes and objects
• Auditory ability to recognize and respond audible speech of various pitch and strength or when lips are not visible (e.g. wearing a surgical mask) or via telephone
• Hear auditory alarms (e.g. patient monitors, fire alarms)
• Olfactory ability to detect odors such as smoke, alcohol, noxious gasses
• Tactile ability to palpate pulses, skin temperature, or palpable masses.

3. Communication Skills

• Ability to read, write, communicate, and understand English (verbally and in writing) with patients, family members, health care personnel, and faculty.
• Adapt verbal communication to patient/visitor limitations (e.g. hearing loss, pediatrics, diminished mental capacity)
• Ability to explain procedure to patient, obtain clinical and medical history from patient or other health care providers, obtain laboratory results, communicate sonographic description of examination findings to physicians and peers.
• Ability to recognize, interpret, and respond to non verbal communication and behavior with others and self. 
• Establish and maintain professional relationships with patients, peers, healthcare providers, and faculty.

4. Behavior Skills

• Provide safe and competent patient care
• Demonstrate/act ethically in the classroom and clinical setting
• Accept feedback in a respectful and professional manner
• Express self in a respectful and professional manner 
• Foster and maintain professional relationships with patients, peers, healthcare providers and faculty. 
• Manage interpersonal and organizational conflicts in a respectful and professional manner
• Adapt to a changing environment (e.g. clinical site rotations, patient schedule changes)
• Monitor own emotional state/manage frustration appropriately
• Accept responsibility for own actions, errors, or imperfections
• Respect interpersonal boundaries

5. Critical thinking and  Cognitive skills

• Recognize cause and effect relationships
• Apply principles, indications, and contraindications for sonographic examinations
• Perform tasks in a logical and efficient sequence
• Prioritize multiple  tasks
• Problem solve when the solution is not self-evident
• Interpret sonographic findings in relation to anatomical presentation, imaging quality, and patient clinical/medical/laboratory results/correlative medical imaging procedures. 
• Demonstrate attention to detail
• Evaluate own performance to determine corrective actions when appropriate