Patient Care, Safety, and Ethics
Safety principles
Understand the ALARA principle and the as-low-as-reasonably-achievable use of ultrasound energy. Know that diagnostic ultrasound has no confirmed harmful effects at typical outputs, but thermal and mechanical indices (TI, MI) should be monitored. Reduce output and exposure time when possible, especially in pregnancy and pediatric imaging. Know transducer cleaning and disinfection, electrical safety, and ergonomic practices to prevent musculoskeletal injury.
Patient care and ethics
Review informed consent, patient identification, privacy (HIPAA-type protections), and professional boundaries. Understand how to handle a patient who declines a study, how to communicate findings within scope, and the duty to report critical findings. Know infection control for TEE probes and the handling of incidental findings.
Traps
Questions may test that ALARA applies to all patients, not only pregnant ones, or that the sonographer should not diagnose to the patient but should escalate critical findings. Another trap: confusing the thermal index (heating) with the mechanical index (cavitation). Watch for questions about consent-consent is a process, not just a signature.
Rule of thumb
When output or time can be reduced without losing diagnostic information, reduce it-ALARA is a continuous judgment, not a one-time setting.
Worked example
A pregnant patient needs a limited cardiac evaluation; lower the output and minimize dwell time while obtaining the necessary views, documenting the indication and the safety adjustment.