Many hospitals have advised they do retain views. They have provided their local fetal cardiac protocol or SoP (Standard Operating Procedure). The following two publications are not compatible with the FASP guidance on fetal cardiac view retention. The following has been referenced by some professionals within the NHS when explaining why their views are retained;
Society and College of Radiographers and British Medical Ultrasound Society (Revised 2018) Guidelines for Professional Ultrasound Practice.
“The compilation of an appropriate number of annotated images that represent the entire ultrasound examination is good practice as it provides the following:
“support for the written report, a second opinion to be given on those parts of the examination that have been imaged, a contribution to clinical governance through audit and quality assurance procedures, a teaching tool, evidence that the examination was carried out to a competent standard, evidence that local guidelines and protocols were followed”.
“Unless the entire examination is recorded it must be recognised that the ultrasound images cannot be fully representative of that examination. The stored images will have been chosen by the ultrasound practitioner as a reasonable selection to support the examination report only. If an abnormality or other pathology has been missed during the real time examination, it is unlikely to have been included on an image”
"The subjectivity and operator dependence of ultrasound imaging needs to be recognised within any audit programme being implemented It should highlight areas where improvements can be made while recognising that resources and support will be necessary to ensure improvements can be implemented. Learning outcomes and actions points are an essential part of this audit programme so that improvement to clinical practice can be monitored, focused and reviewed. Reviewing images and reports is the essential first step in an ultrasound audit programme.
An optimum programme would be to recruit external auditors to review practice, be this neighbouring Trusts or colleagues but it is recognised that this may encounter financial and time constraints.
Updated February 2024. FASP Quality Assurance.
“Reviewing ultrasound images and providing feedback to ultrasound practitioners can help to improve the quality of images”.
“The review of ultrasound images aims to:”, “Provide regular feedback to ultrasound practitioners”, “Encourage shared learning”, “Reviewing ultrasound images is an essential part of the: “practical training process for trainees, induction process for new staff, management of red flags, 3-monthly departmental image review”, “The SSS (dedicated screening support sonographer) should make sure there is a: documented process for departmental review of ultrasound images”
“4.2 Shared learning: Suggestions of local activities to encourage shared learning include: buddy scanning to improve image optimisation, sharing key learning points from all image reviews with the department”.
It seems that all this other guidance also applies...but just not when it comes to our children's hearts.
Full publications can be accessed here;