In light of the increasing number of referrals into adult echo services for outpatient echocardiography imaging of 16-17 year olds, we recommend the following as a practice guideline. Practice will necessarily vary from centre to centre depending upon the availability and interaction with local paediatric echo services.
- It is safe for qualified adult echocardiographers to perform and report transthoracic echocardiography on patients aged 16-17. Standard adult reporting datasets can be used. Adult imaging equipment can be used. Care should be taken over appropriate chaperoning.
- The following caveats are acknowledged:
- Patients aged 16-17 with known complex congenital heart disease should only be scanned by a suitably experienced sonographer in an adult service through agreement between the paediatric and adult teams: this may be deemed appropriate on a case by case basis.
- Patients aged 16-17 in whom the referral question relates to the late effects of COVID-19 (PIMS) should be scanned by specialist paediatric services or adult sonographers with appropriate awareness of the potential pathologies and scanning capabilities to identify coronary aneurysms.
- In an emergency setting an experienced adult sonographer may appropriately be called upon to identify pathology requiring immediate management, for example severe left ventricular dysfunction.
- Escalation pathways for a positive finding of coronary aneurysms should be clearly signposted to the sonographer.
- Experienced sonographers should oversee the triage of these referrals in order to direct patients to the most appropriate service (i.e. adult or paediatric), dependent on the pathology under investigation and/or clinical background of the patient.
BSE Council December 2021