FS 557931
CCPU LOG BOOK
BASIC / ADVANCED
(Please circle one)
FOR
DR
NEONATAL REGISTRAR
HOSPITAL
Page 1 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Serial Number
Date of CPU
Patient’s MRN &
Addressograph
Patient’s relevant
history and clinical
findings
Indication for CPU
Findings of CPU
Supervised by
Supervisor’s
Comments
Supervisor’s Signature
& Date.
Page 2 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
CERTIFICATE
This is to certify that
Dr ………………………….,
has satisfactorily completed the
LOG BOOK requirements for the
Basic CCPU course in Neonatology
with recommended duration of training.
He/she has completed the required scans under
my direct supervision at
Hospital.
Signed by:
Date:
Page 3 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
CERTIFICATE
This is to certify that
Dr ………………………….,
has satisfactorily completed the
LOG BOOK requirements for the
Advanced CCPU Course in Neonatology
with recommended duration of training.
He/she has completed the required scans under
my direct supervision at
Hospital.
Signed by:
Date:
Page 4 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Basic Cardiac Ultrasound Scans
Learning Goals
1.
Understand and appreciate the needs of an infant during scanning
2.
Understand and appreciate the infection risks of scanning
3.
Understand and appreciate the optimal choice of probes and settings for neonatal
scanning
4.
Demonstrate an understanding of the normal anatomical structure of the heart as it
relates to the standard echocardiographic windows
5.
Competently perform 2D imaging of the neonatal heart using the parasternal long
axis, short axis, high parasternal ductal/arch view, apical and subcostal
echocardiographic windows
6.
Use of M mode to measure the LA:Ao ratio and assess left ventricular contractility
7.
Use of pulsed wave Doppler and colour Doppler as to demonstrate normal blood
velocities across heart valves and through the outflow tracts.
8.
Understand the common conventions of cardiac scanning and competently
record a series of images to clearly demonstrate normal cardiac anatomy
9.
Competently interpret the heart ultrasound findings in relation to the clinical
Scenario
10.
Need to recognise when
referral should be mandatory because of an incomplete scan or a possible
anatomical or functional abnormality
Signed by:
Date:
Page 5 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Basic Cranial Ultrasound Scans
Learning Goals
1.
Understand and appreciate the infection risks of scanning
2.
Understand and appreciate the optimal choice of probes and settings for neonatal
scanning
3.
Demonstrate an understanding of normal cranial anatomy
4.
Competently use coronal and sagittal cranial ultrasound windows via anterior
fontanelle to demonstrate normal anatomical structures.
5.
Recognise intracranial bleeding with competent assessment of sub-ependymal,
intraventricular and parenchymal bleeding
6.
Understand the common conventions of cranial scanning and competently record a
series of images to clearly demonstrate normal cranial anatomy
7.
Need to recognise when referral should be mandatory because of an incomplete scan
or a possible anatomical or functional abnormality
8.
Competently interpret the ultrasound findings in relation to the clinical scenario
Signed by:
Date:
Page 6 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Advanced Cardiac Ultrasound Scans
Learning Goals
1.
Demonstrate an understanding of the normal anatomical structure of the heart
as it relates to the standard echocardiographic windows
2.
To attain proficiency in image optimisation in order to enable appropriate assessment
of common patterns of Congenital Heart Disease.
3.
Recognise common patterns of Congenital Heart Disease
4.
Assessment of size and shunt direction of the patent ductus arteriosus
5.
Measure Right and Left Ventricular Output
6.
Measure Superior Vena Cava Flow
7.
Assess myocardial function using M-mode and other means
8.
Recognition of common Congenital Heart Disease (CHD) including, when to involve a
Paediatric cardiologist as set out in the “Appropriate Use’ Statement.
9.
Recognise indirect markers to the presence of CHD e.g. large or small vessels and
chambers, abnormal movement of myocardium or valves.
10.
Assessment of baby with cyanosis of unknown cause - Recognise echocardiographic
features of PPHN
11.
Recognise common cyanotic CHD that can mimic PPHN (e.g TAPVC, TGA)
12.
Recognise other common cyanotic CHD including ductal dependent
pulmonary circulations
13.
Recognise other common CHD o Recognitions of muscular and peri membranous VSDs
o Pulmonary Stenosis
o Fallots Tetralogy
o A-V Canal Defects
Signed by:
Date:
Page 7 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Advanced Cranial Ultrasound Scans
Learning Goals
1.
2.
Competently use coronal and sagittal cranial ultrasound windows via anterior
fontanelle to demonstrate normal anatomical structures.
Recognise intracranial bleeding with competent assessment of sub-ependymal,
intraventricular and parenchymal bleeding
3.
Recognise common structural abnormalities of cerebral development
4.
Be able to perform and interpret Doppler studies of the anterior and middle
cerebral artery
5.
Be able to perform and interpret studies of mastoid, temporal and posterior fontanelle
views
6.
To recognise the common parenchymal and Doppler changes seen in the
asphyxiated infant
7.
Need to recognise when referral should be mandatory because of
an incomplete scan or a possible anatomical or functional abnormality
8.
Competently interpret the ultrasound findings in relation to the clinical scenario
Signed by:
Date:
Page 8 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931
FS 557931
Advanced Abdominal Ultrasound Scans
Learning Goals
1.
Demonstrate an understanding of Normal abdominal anatomy
2.
Demonstrate an understanding of Anatomy and relationships of major organs
3.
Demonstrate an understanding of Anatomy and relationships of IVC and abdominal
aorta
4.
Attain proficiency in image optimisation in order to enable appropriate demonstration
of the IVC and abdominal aorta including umbilical catheter and PIC tip location
5.
Attain proficiency in image optimisation in order to enable appropriate demonstration
of the Location and identification of the kidneys
6.
Attain proficiency in image optimisation in order to enable appropriate demonstration
of the Bladder location and assessment of relative volume
7.
Need to recognise when referral should be mandatory because of
an incomplete scan or a possible anatomical or functional abnormality
8.
Competently interpret the ultrasound findings in relation to the clinical scenario
Signed by:
Date:
Page 9 of 9
07/15
Australasian Society for Ultrasound in Medicine PO BOX 943, Crows Nest NSW 1585, SYDNEY, AUSTRALIA
P (61 2) 9438 2078 F (61 2) 9438 3686 E asum@asum.com.au W www.asum.com.au
ACN 001 679 161 ABN 64 001 679 161 ISO 9001 certified by BSI under Certificate No. FS 557931