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Cardiac Echocardiography

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Ultrasound Echocardiography

Adult Echocardiography *

Pediatric Echocardiography *

Fetal Echocardiography *

Trauma Echocardiography *

Stress Echocardiography *

Treadmill Testing *

Dobutamine *

Pharmacologic Stress Echo *

Transesophageal Echocardiography (TEE) *

Intraoperative Echocardiography *

Contrast Echocardiography *

Myocardial Contrast *

Echo-Guided Procedures *

Plethysmography *

Doppler Vascular Procedures *

Pressure Measurements *

Two-Dimensional Mode *

Three-Dimensional Mode *

M-Mode *

Ped Off Probe *

Pulsed Wave Doppler *

Continuous Wave Doppler *

Color Doppler Mapping *

Portable Studies *

Invasive Procedure Guidance *

EKG/ECG *

Parasternal Long Axis View *

RVIT *

RVOT *

Parasternal Short Axis View *

4 Chamber View *

2 Chamber View *

Apical Long *

Subcostal View *

Subcostal Short Axis of RV Inflow and Outflow *

IVC *

Hepatic Veins *

Abdominal Aorta *

Suprasternal Notch *

Simpson's Rule *

Proximal Isovelocity Surface Area *

Diastolgy with TDI *

Continuity Equation *

Pediatric Echo

Two-Dimensional Mode *

Three-Dimensional Mode *

M-Mode *

Ped Off Probe *

Pulsed Wave Doppler *

Continuous Wave Doppler *

Color Doppler Mapping *

Portable Studies *

Invasive Procedure Guidance *

EKG/ECG *

Parasternal Long Axis View *

RVIT *

RVOT *

Parasternal Short Axis View *

4 Chamber View *

2 Chamber View *

Inverted Apical 4 Chamber View *

Inverted Apical 5 Chamber View *

Subcostal Long View *

Subcostal Long with Sweep *

Subcostal Short with Sweep (Bi Caval View) *

Subcostal Aortic Arch *

Subcostal Abdominal Aorta *

Subcostal Situs View *

Suprasternal Notch View - Long *

Suprasternal Notch View - Short *

Meditech Left Atrium with Pulmonary Veins with Suprasternal Notch *

Pulmonary Artery Branches *

Ductal View *

Arch Sidedness *

Scanning Complex Anomalies *

Scanning Post-Surgical Repairs *

Simpson's Rule *

Proximal Isovelocity Surface Area *

Diastology *

Stress Echo *

Continuity Equation *

Equipment

Phillips *

Siemens *

Toshiba *

Hitachi *

General Electric *

HP *

Other *

Age Specific Experience

Newborn/Neonate (birth to 30 days) *

Infant (1 month to 1 year) *

Toddler (1 year to 3 years) *

Preschooler (3 years to 5 years) *

School Age Child (5 years to 12 years) *

Adolescents (12 years to 18 years) *

Young Adults (18 years to 39 years) *

Middle Adults (39 to 64 years) *

Geriatric Adults (65+ years) *

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