Emergency Point of Care Ultrasound Endorsement (EPOCUS)

Emergency Point of Care Ultrasound Endorsement (EPOCUS)?

The Emergency Ultrasound Endorsement is a mechanism to designate those healthcare providers who have obtained the requisite skills set for integration of the emergency ultrasound devices into emergency assessment and procedures. This endorsement is meant to show the individual possesses the basic knowledge and skills necessary to provide integrated emergency assessment with an ultrasound device at patient’s bedside.

What is the Scope of Practice for EPOCUS?

There is an evolving spectrum of training in clinical ultrasound from undergraduate medical education through post-graduate training, where skills are introduced, applications are learned, core concepts are reinforced and new applications and ideas evolve in the life-long practice of ultrasound in emergency and critical care medicine.

Competency in emergency ultrasound requires the progressive development and application of increasingly sophisticated knowledge and psychomotor skills for an expanding number of emergency and critical care ultrasound (EUS) applications. This development parallels the performance of any EUS exam.

The ACEP definition of ultrasound competency includes the following components:

  1. The clinician needs to recognize the indications and contraindications for the EUS exam.
  2. The clinician must be able to acquire adequate images. This begins with an understanding of basic US physics, translated into the skills needed to operate the US system correctly (knobology), while performing exam protocols on patients presenting with different conditions and body habitus.
  3. Simultaneous with image acquisition, the clinician needs to interpret the imaging by distinguishing between normal anatomy, common variants, as well as a range of pathology from obvious to subtle.
  4. The clinician must be able to integrate US exam findings into individual patient care plans and management.

For Endorsement in Point of Care Ultrasound, the healthcare provider must:

  1. Participants will review a basic approach to ultrasound physics.
  2. Participants will be able to demonstrate the operation of the ultrasound with the correct pressure, alignment, tilt, and anatomical orientation to provide a proper ultrasound image suitable for interpretation.
  3. Participants will be able distinguish between normal anatomy, common variants, and abnormal finding in specific standard exams.
  4. Participants will be able to demonstrate a BLUE Protocol Exam.
  5. Participants will demonstrate the RUSH Exam.
  6. Participants will be able to demonstrate a CAUSE Exam.
  7. Participants will be able to demonstrate the FOCUS exam.
  8. Participants will be able to demonstrate peripheral/deep venous access with ultrasound.
  9. Participants will be able to demonstrate ultrasound guided pericardiocentesis.
  10. Participants will demonstrate the ability to access peripheral nerves and perform ultrasound guides nerve block.

Responsibilities of Registry Certified Personnel:

Certified personnel must notify the Registry within 30 days regarding the following matters:

  1. Change in mailing address (the best way to update a mailing address is by editing your account profile)
  2. Any criminal conviction.
  3. Disciplinary action taken by any agency having jurisdiction (or government body) that has resulted in suspension, revocation, or expiration of registration/licensure; termination of right to practice; voluntary surrender of registration/licensure while under investigation.

The Registry considers the individual to be solely responsible for their certification and reporting, any failure to follow process or report as required is solely the failure of the certified person and may result in immediate dismissal of their certification, as well as, immediate notification to any pertinent regulatory agency of their dismissal.

Disciplinary Policy and Rights of Appeal for The Registry can be found on The Registry website.

Requirements for Initial Registration (Certification):

Individuals applying for certification must meet the following requirements:

  1. Candidate must be 19 years of age or older
  2. Successful completion of a registry accredited ultrasound education program that meets or exceeds the Registry Education Standards.
  3. Candidate must have completed the course within the past year and the course Program Director must verify successful course completion on the Registry website.
  4. Candidate must document 10 successful ultrasound assessments of each RUSH, FOCUS, CAUSE, and Blue Protocol with instructor oversight.
  5. Candidate must successfully complete the Registry cognitive (knowledge) exams. Passed portions of the examination (cognitive) remain valid for 12 months.

Application Process

  1. Create an account on the Registry website.
  2. Submit a Registry application and answer all questions truthfully.
  3. The Registry may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a criminal conviction has occurred.
  4. Pay the application fee of $150 usd.
    1. The application fee is non-transferable and non-refundable.
    2. This fee is charged for each attempt at the cognitive examination.
  5. Candidates will receive an electronic Authorization to Test (ATT) once you are eligible for the exam.
    1. The electronic ATT contains scheduling instructions and important details concerning proper identification required at testing centers.
    2. You can find the ATT in the “Alerts” section of your account page.
    3. The ATT is your test key and you will need to carry it with you to a testing center to be provided access to your examination.