Perspectives
Both NICE and the RCR have made recommendations concerning EMUS and both documents have been influential in the uptake of EMUS:
Two-dimensional imaging ultrasound guidance is recommended as the preferred method for insertion of central venous catheters into the internal jugular vein in adults and children in elective situations. This should be considered in most clinical circumstances where central venous catheters insertion is necessary either electively, or in an emergency situation.
All those involved in placing such cannulae using ultrasound guidance should undertake appropriate training to achieve competence. The training involves not only acquiring the necessary manual skills, but also having a basic understanding of ultrasound principles and being able to interpret ultrasound images.
In January 2005, the Royal College of Radiologists (RCR) published guidelines for non-radiologist ultrasound practice. The document was updated in 2012 and describes three levels of training. It highlights recommended competence for each level and provides guidance for use of ultrasound by non radiologists in all areas where ultrasound is being used clinically. Specific guidance can be found for focussed emergency ultrasound.