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Dear ASA member,
I apologise greatly for not responding to your enquiry sooner.
Please see below the advice and the relevant documents.
kind regards,
Alison White
As the Chair of the Cardiac SIG, I agree with the comment posted below by Kim Prince.
In Australia, we follow the guidelines from the American Society of Echocardiography (ASE), the American College of Cardiology (ACC) and the American Heart Association (AHA). The ACC/AHA clinical competence statement on echocardiography states that a transoesphageal echocardiogram (TOE) is performed by a physician, where physician is defined as a licensed practising medical doctor.
As outlined by Kim Prince in her comment below, in Australia, sonographers are to work within their scope of practice which covers transthoracic echocardiograms, not transoesphageal echocardiograms (see the attached PICSA document in Kim's comment).
In addition, The Cardiac Society of Australia and New Zealand (CSANZ) provides position statements on training and performance in echocardiography, including TOE. See the attached document. (CSANZ Position Statement for Training and Performance in Adult Echocardiography). This document outlines that TOE is part of Level 2 training for cardiologists (not sonographers).
kind regards,
Alison White
Kim Prince:
Thank you for this enquiry.
In Australia Transoesophageal echo's (TOE's) are performed by qualified imaging cardiologists (or anesthetists in surgery).
Cardiac sonographers are not qualified to perform a TOE in Australia. Qualified cardiac sonographers can assist the cardiologist with machine functions and if necessary hold the TOE probe while the doctor gets into position, however, inserting the TOE probe or operating the TOE probe to perform the test is outside of the cardiac sonographers scope of practice in Australia. I have attached a document in regard to scope of practice for cardiac testing for your information, however it does not cover TOE as it is not a procedure sonographers perform.
I have also attached the Qld Health TOE consent form which at the end just explains that the doctor will be performing the test.
I hope this assists you. Medicare may also be able to provide additional information that I could not find on their item list.
Please contact us if you have any further questions.