Sonography in the ER - Society of Diagnostic Medical Sonography

SDMS News Wave February 2009 1
SDMS News Wave is published to inform
SDMS members of meetings, events and
policies as well as trends and issues in
the sonography profession. Comments,
questions or concerns about the articles
appearing in SDMS News Wave, should be
directed to newswave@sdms.org.
Sonography in the ER
Emergency Ultrasound’s Expanding Role
By Beth W. Orenstein
These days, Charlotte Henningsen’s students at
Florida Hospital College in Orlando, FL, include
not only future sonographers but also emergency
medicine physicians. “As of June, Florida Hospital,
which is part of the Adventist Health System,
began an emergency medicine residency program,
and I have been working with the director of
ultrasound for emergency medicine in helping
teach the emergency medicine physicians the core
curriculum for ultrasound,” says Henningsen, MS,
RT, RDMS, RVT, FSDMS, chair and professor
of the sonography department. As it is with
sonography students, the residents’ education
in sonography is a combination of lecture, lab,
and clinical experience. “So we bring them to the
sonography lab at the college,” she says.
Ultrasound was not always seen as an
emergency diagnostic tool or treatment aid. But
as manufacturers began to produce high quality
ultrasound equipment that is smaller and more
portable and less expensive, clinicians from many
specialties have discovered the value of bringing
ultrasound to the patient’s bedside in the ER. Paul
Sierzenski, MD, RDMS, Director of Emergency,
Trauma and Critical Ultrasound and the Emergency
Ultrasound Fellowship at Christiana Care Health
System in Newark, DE, and a member of SDMS,
says emergency medicine in the United States
has used sonography to identify a limited number
of conditions (pericardial effusions and intraabdominal
free fluid) since the mid to late 1980s.
In the past decade, however, sonography’s use in
the emergency department has expanded dramatically.
Focused emergency ultrasound is rapidly
becoming a standard of care. It is now being
In this issue
cover story: Sonography in the ER • 4 Do You Have Trouble Deciding What is Legal, Ethical or Legal
But Not Ethical? • 5 Upcoming SDMS Webinars • 6 SDMS Fellow Spotlight • 7 Member Benefit Spotlight - Long
Term Care Insurance • 8 New Member Scan • 9 SDMS Answers Your Calls • SDMS Member Benefit Change
• 10 Fire Sale! • 11 Product Spotlight • Make Your Way to Music City! • 12 SDMS Welcomes New Members
Society of Diagnostic Medical Sonography
www.sdms.org

utilized to diagnose acute life-threatening conditions,
guide invasive procedures, and treat emergency medical
conditions in community and academic hospitals of all
sizes worldwide. Researchers, such as Dr. Sierzenski,
continue to collaborate and expand the applications
and impact of point-of-care ultrasound in emergency
medicine and clinical specialties. The result, says the
American College of Emergency Physicians (ACEP) in
its October 2008 Policy Statement on Emergency Ultrasound,
“is to improve the care of countless patients all
around the globe.”
Most emergency departments, whether in small
community hospitals or large academic centers, do
not have sonographers dedicated to that department.
In most cases, if the emergency physicians want a
focused sonogram to aid in their diagnosis or guide an
emergency procedure, they perform it themselves. “At
some institutions, you are seeing sonographers being
increasingly asked to perform these point-of-care tests,
but in general, and from the standpoint of the ACEP, it is
intended to be physician performed,” Dr. Sierzenski says.
In response to the growing demand for sonograms in
the emergency department, The Residency Review
Committee for Emergency Medicine (RRC-EM)
mandates emergency medicine residencies train
their residents in emergency ultrasound as part of
their standard curriculum. Additionally, the American
College of Emergency Physicians and the Society
for Academic Emergency Medicine support it as best
practice for emergency medicine. The American College
of Surgeons also has included ultrasound as one of
several “new technologies” that surgical residents must
be exposed to in their curriculum. As a result, some
sonography professors, such as Henningsen, are
finding their newest students are residents in emergency
medicine and other disciplines. Henningsen doesn’t
know how many of her colleagues at other health
sciences colleges with accredited sonography programs
are teaching emergency medicine residents, “but I know
across the U.S. there are others,” she says. “I know I am
not the only one.”
“The ultimate goal of (the
resident’s) use of emergency
ultrasound is to affect patient
care in a positive way, and it’s
hard to argue with that”
Some in the sonography community are concerned
that the residents are not getting adequate education
and training in sonographic procedures. But seeing
and participating in the education some physicians
SDMS News Wave February 2009 2
are receiving, Henningsen believes the concern is
unfounded. “The fact is, it is part of emergency medicine
residency now,” Henningsen says. “Emergency medicine
physicians who are in current residency programs should
be receiving that education, which may or may not
include education by a sonographer.”
“For me,” she adds, “it’s very beneficial to work within
their guidelines and see the kind of education they are
receiving and also to see that their focus is really limited
to truly emergency ultrasound. The ultimate goal of their
use of emergency ultrasound is to affect patient care in a
positive way, and it’s hard to argue with that.”
To prove their competency, some emergency
physicians have earned credentials from the American
Registry for Diagnostic Sonography (ARDMS) just as
many sonographers do. David Bahner, MD, RDMS,
Emergency Ultrasound Directror at Ohio State University
Medical Center and a member of SDMS, passed his
registry exam and was certified in 2000, five years after
graduating from medical school. “I went and took some
courses during my residency and after,” he says, “and
then I went back and got my RDMS in 2000 because
there wasn’t a method for physicians outside of radiology
to document their ultrasound expertise.” (He used
prerequisite 4B to qualify for the registry.) ACEP has
looked at formalizing a certification (possibly hospital
boards credential, organizations certify) process for
emergency physicians in sonography, Bahner says, and
if it does, emergency physicians may opt for that route.
“Currently, if you complete an emergency medicine
fellowship, it ends with you having to pass RDMS
certification,” Bahner notes. Bahner supports formalizing
the certification process as part of residency training and
even in to medical school. “The clinician of tomorrow
must have the experience to ensure patients that the
physicians’ minimum competency in their emergency
practice of sonography,” he says.
Emergency ultrasounds are different from the
comprehensive sonographic exams or complete studies
performed by sonographers in hospitals, physicians’
offices, and imaging centers, Henningsen says. In most
cases, emergency ultrasound is rather a highly focused,
limited, goal-directed exam with the expressed purpose
of answering a select set of questions, Dr. Sierzenski
says. Such questions might include: Does the patient
have gallstones? Is a pericardial effusion present?
Is there an abdominal aortic aneurysm (AAA) or a
foreign body? “There are times when the emergency
physician who is evaluating the patient can answer a
question faster if he can pull an ultrasound machine to
the bedside,” Henningsen adds. However, she says, the
emergency physician’s use of emergency ultrasound is a
limited scope of practice.
ACEP’s 2008 Policy Statement identifies five clinical
reasons for emergency ultrasounds: one is resuscitative,

where ultrasound use is directly related to an acute
resuscitation; two is diagnostic, where ultrasound is
utilized in an emergent diagnostic imaging capacity;
three is symptom or sign-based, where ultrasound used
in a clinical pathway based upon the patient’s symptom
or sign (e.g., shortness of breath); four is procedure
guidance, where ultrasound used as an aid to guide
a procedure; and five is therapeutic and monitoring,
where ultrasound used in therapeutics or in physiological
monitoring.
Most sonograms performed in the emergency
department are problem based and fall into one of
several categories: abdominal, pelvic, cardiac, trauma
and miscellaneous. “Miscellaneous exams” include such
applications as ocular, soft tissue and musculoskeletal.
The exams remain problem focused such as loss of
vision looking for retinal detachment in ocular ultrasound,
Dr. Bahner says.
Many people show up in the emergency room
complaining of abdominal pain. Emergency physicians
spend a great deal of time and hospital resources
to determine the cause of the pain. Possible causes
include problems with the gallbladder or kidney or
an abdominal aortic aneurysm (AAA.) An emergency
sonogram often can aid in the diagnosis of all three of
these potential sources of problems. The diagnosis can
be more complicated when patient has other diseases
or conditions such as diabetes or peptic ulcer disease,
Dr. Sierzenski says. A screening sonogram can help
the physician determine if the patient has gallbladder
disease or gallstones, which are visible only 15% of the
time on conventional X-ray. The results can tell whether
the patient needs treatment or can be sent home to be
examined later by a primary care physician, he says.
If a patient has an abdominal aortic aneurysm, his/
her survival may be dependent on a rapid diagnosis.
Patients who come to the emergency department with
an AAA don’t always have the classic symptoms, making
it easy to miss or delay their diagnosis, Dr. Sierzenski
says. Angiography and computed tomography (CT) with
contrast could provide more specific results. However,
a sonogram is often a rapid and effective alternative,
especially in a busy ER where the wait for a CT scan can
be an hour or two. A study presented at a meeting of the
Society for Academic Emergency Medicine found that
a decrease in the time to diagnosis markedly improved
the outcomes of patients with ruptured AAA. The group
diagnosed by ultrasound had a significantly improved
mortality rate. “This is one of the areas that I really think
sonograms in the emergency room can affect change,”
Henningsen says, “because it can get patients to the
operating room more quickly and potentially decrease
mortality rates. Aortic rupture is one of those events that
comes with high mortality rates, because patients bleed
out and die before they can get them to the operating
room.”
SDMS News Wave February 2009 3
“This is one of the areas that I
really think sonograms in the
emergency room can affect
change, because it can get
patients to the operating room
more quickly and potentially
decrease mortality rates.”
In most trauma centers, focused assessment with
sonography for trauma (FAST) has replaced diagnostic
peritoneal lavage (DPL) for detection of intraperitoneal
blood. A CT scan will provide excellent detail of
the organs in the abdomen, but the E-FAST exam,
which is performed by utilizing four or more views,
is far less expensive, delivers no radiation, and can
be easily repeated, Dr. Sierzenski says. The FAST
exam allows the ER physician to rapidly assess the
patient’s condition, reassess it, and send the patient for
appropriate treatment, which may require emergency
surgery. The American Institute for Ultrasound in
Medicine (AIUM) put practice guidelines for the FAST
exam in place as of Oct. 1, 2007, Henningsen says. “But
the FAST exam, of course, has been around longer than
that.”
A number of diagnostic imaging tools can be used to
determine whether a patient has kidney stones, including
ultrasound. The advantage of emergency ultrasound
if kidney problems are suspected is that it is can be
done within five minutes at the bedside. In this situation,
ultrasound is also useful because it is safer in patients
who are allergic to dyes, may have congestive heart
failure, or who may be pregnant.
Emergency ultrasound also can be used to evaluate
pregnancy in the first trimester. “It is primarily used
to rule out an ectopic pregnancy,” Henningsen
says. “Again, that can be a life-threatening, surgical
emergency.”
Emergency medicine physicians also are performing
emergency echocardiography, primarily to identify the
presence of cardiac activity. “They’re using sonography
to determine whether or not they need to proceed with or
stop CPR and for the presence of pericardial effusion,”
Henningsen says. A patient may not have electrical
cardiac activity, but pulseless electrical activity (PEA)
does not necessarily mean the heart is not beating. If
physicians are able to detect cardiac activity and can
correct the low flow state, it may be lifesaving.
Additional uses of emergency ultrasound include the
detection of deep vein thrombosis (DVT), foreign bodies

and pleural effusions, pneumothorax and aiding in the
placement of a central venous access line. “Central
venous access studies were previously done with
landmark techniques – essentially blind,” Henningsen
says. “So they have really increased accuracy and
decreased complications by using sonography to assist
in these procedures.”
While the number of applications for emergency
ultrasound is increasing, it will not replace
comprehensive sonograms. Henningsen sees
opportunities in the emergence of emergency ultrasound
for sonographers. They may find work in an emergency
department, “especially in large, busy departments,
where they are doing a lot of sonographic procedures,”
she says. Also, she says, sonographers may be pulled
from other departments to perform portable sonograms
in the ER beyond the limited scope that emergency
physicians are doing.
“The one thing a general sonographer may not be
familiar with is the components of the e-FAST exam,
because it was really developed for emergency
medicine,” Henningsen says. “There may be
sonographers who are doing sonography in the
emergency room where they have learned this protocol.”
Sonographers typically have not done the ultrasoundguided
procedures in the emergency room either,
because in the past the procedures were done blind
using landmark techniques, she notes.
While sonography is now part of the emergency
medicine physician’s training, it will take some time for
everyone to be trained. “It’s going to take some time,
SDMS News Wave February 2009 4
because there are still emergency physicians who went
through their residencies without this being part of the
curriculum, but this is current residency curriculum, and
so we’re going to see it continue to grow,” Henningsen
says.
Everyone expects that physicians will continue to find
additional uses for ultrasound in emergency medicine.
However, Henningsen says, “I don’t think it’s going to
replace what radiology ultrasound and cardiovascular
ultrasound is currently doing. This is one of those
emerging technologies, and what we’re seeing right
now is growth in the sonography field but the growth
has been within emerging technologies like emergency
medicine and anesthesiology.”
As ultrasound equipment is miniaturized and the
technology continues to improve, it’s a natural evolution
for sonography to play a greater role in diagnosis and
treatment at the bedside, Drs. Sierzenski and Bahner
agree. “All you need to do is look at the companies that
are developing portable compact systems – you have
almost every major player in this country and abroad,”
Bahner says, “and you can see that ultrasound is being
not only embraced but adapted and changing how
medicine is practiced in the emergency department
and in the operating room and in the intensive care unit
(ICU) and even in internal medicine and family medicine.
Ultrasound has been called the stethoscope of the 21st
Century. We are a long way off from that [being] reality,
but it is being used in critical scenarios in response to
physiological stressors.”
Beth W. Orenstein is a writer for SDMS.
Do you have trouble deciding
what is legal, ethical or legal
but not ethical?
Check out the feature article, “More Questions Than Answers?” by
Paul R. Genender currently posted on the ADVANCE for Imaging and
Radiation Therapy Professionals website. The article explores the
definition of ethics, the power of compassion and how to protect yourself
if in an ethical dilemma.
http://imaging-radiology-oncology-technologist.advanceweb.com/
Paul R. Genender is a partner at K&L gates LLP and serves as the outside
legal counsel to SDMS.

SDMS News Wave February 2009 5
Upcoming
SDMS Webinars
Participate in live presentations or watch the recordings
at your convenience. Then take the test for instant CME
credit, absolutely free for SDMS members.
The SDMS Webinar Series is a series of live or
recorded CME presentations delivered via the Internet
to SDMS members conveniently to their home or
work computer. Using your computer and a phone,
you have access to exciting information presented by
world-class sonographers.
The SDMS Webinar Series is available
FREE to current SDMS members.
If you are unable to participate in these live webinars,
visit http://www.sdms.org/members/webinars.asp
for information on viewing a recording of the webinar.
Registration: The SDMS Webinar Series is FREE to
current SDMS members and is not available to nonmembers
(For information on joining SDMS, visit
http://www.sdms.org/membership/ )
“ The event was just the right content and length
of time.
As soon as the event ended, I went to the CME
test and received my certificate. I was extremely
happy to see the test was available immediately
while content was fresh in my mind.
Easy way to obtain CME’s”
– Cindy Herbert, SDMS Member
All SDMS Webinars are tracked
by SDMS CME Tracker.
http://www.sdms.org/members/
webinars.asp
The Role of the JRC-DMS in the Process of
Programmatic Accreditation
Date: Thursday, March 19, 2009
Time: 8:00 pm (Eastern); 7:00 pm (Central);
6:00 pm (Mountain); 5:00 pm (Pacific)
CME Credits: 1.0 SDMS CME Credit (OT)
FEATURED SPEAKER:
Kathryn (Katie) Kuntz, MEd, RT(R), RDMS, RVT, FSDMS
Renal Transplant
Date: Thursday, March 26, 2009
Time: 8:00 pm (Eastern); 7:00 pm (Central);
6:00 pm (Mountain); 5:00 pm (Pacific)
CME Credits: 1.0 SDMS CME Credit (AB)
FEATURED SPEAKER:
Salvatore LaRusso MEd, RDMS, RT(R)
ARDMS Sonography Principles &
Instrumentation (SPI) Examination Information
Date: Thursday, April 2, 2009
Time: 8:00 pm (Eastern); 7:00 pm (Central);
6:00 pm (Mountain); 5:00 pm (Pacific)
CME Credits: 1.0 SDMS CME Credit (OT)
FEATURED SPEAKERS:
Gwen Henderson, Trish McConkey, Ellen Julian, Jessica McLane Gann,
Pat Grier, and Morgan Kreutz
Pulmonary Hypertension
Date: Thursday, April 16, 2009
Time: 8:00 pm (Eastern); 7:00 pm (Central);
6:00 pm (Mountain); 5:00 pm (Pacific)
CME Credits: 1.0 SDMS CME Credit (OT)
FEATURED SPEAKER:
Margaret Park BS, RVT, RDCS, FASE

SDMS Fellow
Spotlight
SDMS News Wave February 2009 6
This is a continuing series of interviews of
our distinguished SDMS Fellow members.
Roger W. Warner, MS,
RDMS, RDCS, FDMS
Year awarded fellow
status: 1994
Current position:
Chief Operating
Officer of Women’s
Healthcare of Illinois,
Evergreen Park
What inspired you to start your career in
sonography?
It was purely by chance. I had graduated from
Seattle Pacific University in 1974 with a B.S.
degree in biology. Don Baker was at the University
of Washington doing research with Doppler and
ultrasound and he hired me. The reason he did
was because one of my friends from college
had been working for him and was leaving. The
college recommended me to take his place. When
I graduated from college, I didn’t know anything
about ultrasound and two weeks later I was working
for the University of Washington.
How did sonography take you to where you
are now?
Because I had a bachelor’s degree, I was in
somewhat of unique position in the ultrasound
community. Not many had bachelor’s degrees
back then. I moved from Seattle to Rochester,
N.Y., to replace Jean Lea Spitz at the University
of Rochester. I got involved with a local college
and developed a bachelor’s degree program in
ultrasound and started working on my master’s
degree while I was running the program. From
there I went to Dayton, Ohio, to manage a perinatal
imaging center with Wright State University School
of Medicine. After I received my master’s in health
administration in 1988, I wanted to do some new
things and went to work for a consulting firm and
became involved in business consulting activities
with hospitals and physicians. I was recruited to
Chicago in 1994 as vice president of physician
services for a hospital. After five years, I became
the CEO of an orthopedic group for seven years
and then was offered my current job as chief
operating officer of an ob-gyn group.
Did you have a memorable role model/teacher?
I had the wonderful opportunity to work with some
incredibly gifted sonographers, not just in the
clinical arena but also within the SDMS. Don Baker
hired me out of college in 1974 and soon thereafter
I met Joan Baker. I moved to Rochester in 1977 to
take the job that opened when Jean Spitz moved
to Oklahoma. Mimi Berman gave me a job editing
manuscripts in 1978 with Medical Ultrasound and
also was instrumental in helping me develop the
baccalaureate program at the Rochester Institute
of Technology. I served on the SDMS Board of
Directors for eleven years and so many people
mentored me both professionally and personally.
In no particular order, and at the risk of forgetting
someone I haven’t already mentioned, I would
like to thank the following people: Beth, Diane(s),
Gwen, Steve (I miss you), Kevin, Terry, Dale, Reva,
Laurinda, Marilyn, Larry, Sandy, Wayne, Carol,
Linda, Julia, Marveen, Jim, Jeanette, Carolyn,
Marie, Pam, Rebecca, Alan and many more who
have been a blessing to me. If you want to catch
up please call me at 708-422-7258 or email me at
rwarner1710@aol.com.
What advice would you give to students/ future
sonographers?
Never stop learning. Get as much education as
you can. It helps you in all phases of your life, not
just the medical side. Finally, become involved
with the SDMS and network with your colleagues.
There were so many people who challenged and
supported me while I served on the SDMS board.
My experience was so fulfilling and I owe them a
big debt of gratitude.

Member Benefit Spotlight:
Long-Term
Care Insurance
SDMS is pleased to announce the addition of
another benefit to our already comprehensive list of
benefits available exclusively to SDMS members.
The Society has teamed up with LTC Global to
provide a long-term care insurance plan for your
consideration. LTC Global is an organization of
long-term care professionals who specialize in
providing this type of insurance coverage. They
will take the time to work with you to assess your
needs and suggest a plan that is right for you, and
your budget. The coverage is underwritten through
stable, well-known, reputable insurance companies.
These companies are selected based on their
experience, independent ratings and customer
credibility. Additionally, the companies who are
underwriting this program have demonstrated their
commitment to their policyholders by providing
attractive policy benefits, competitive pricing and an
established history of no-hassle claims-payment.
What is long-term care insurance?
• Long-term care insurance pays for services that
are typically not paid by traditional medical and/
or nursing care coverage, and is often used
by people with disabilities or chronic illnesses.
Long-term care insurance is not typically
covered under ordinary health insurance, and is
often very expensive. Life savings, or retirement
savings, could quickly be depleted if you should
encounter a serious health problem that is
chronic in nature. Also, Medicare will only pay
for these kind of services if you have already
exhausted your savings and any other assets.
• Long-term care insurance will normally cover:
- Home care assistance with daily activities like
bathing, dressing, eating and cleaning.
- Adult day care and other related community
programs.
- Residential assisted-living services (other
than your own home), that may include
SDMS News Wave February 2009 7
meals, health monitoring, and help with daily
activities.
- Visiting nurse care.
- Nursing home care.
• Middle-age may be the best time to qualify for
and acquire long-term care insurance - it is this
time of life when you are most likely to be eligible
for issuance of a long-term care policy and the
premiums costs may be lower.
Long-term care insurance may not be for everyone,
but it’s a good idea to consider, given that more
than 80% of sonographers report periods of
“scanning in pain”, and 20% of the sonographer
population eventually experience a career-ending
musculoskeletal disorder (MSD) injury. Your
goals are likely to include protection of your
assets, minimizing your dependence on other
family members, and controlling where and how
you receive long-term care services. This SDMS
benefit is particularly important for those members
who are planning for retirement, and interested in
stretching post-retirement dollars.
Important questions, and answers relating to the
SDMS program, when thinking about long-term
care coverage are:
Q. Are you required to spend time in a hospital
before receiving benefits?
A. The SDMS LTC program coverage does not
require a hospital stay to qualify for benefits.
Q. Is your coverage guaranteed renewal as
long as you pay the premiums?
A. Yes.
Q. Can you stop paying premiums once you
begin receiving benefits?
A. Yes, premium payments are waived once
benefits begin and continue to be waived for the
duration of the claim.
Q. How many deductibles does the policy
have?
A. Coverage is available with and without
deductibles, depending on your preference.

Q. Will the policy cover pre-existing conditions
if you disclosed them when you applied?
A. Yes.
Q. Are there choices for inflation protection or
a guaranteed right to increase your benefit?
A. Yes, options are available for compound and
simple inflation.
Q. Can you downgrade your coverage if you
cannot afford the premiums?
A. Yes, coverage can be lowered at any time
without having to prove insurability.
Q. Does the coverage include dementia?
A. Yes.
Q. Is nursing care and home health care
coverage provided?
A. All policies include benefits for nursing home,
assisted living, home health care, and adult day
SDMS News Wave February 2009 8
care. You select a daily benefit, a maximum
lifetime benefit, an elimination period, and
inflation protection. Other optional benefits are
also available depending on the carrier.
Q. Is there a right to cancel the policy for any
reason within 30 days of purchase and
receive a refund?
A. Yes.
To apply or get more information about
this coverage, call 888-305-4LTC (4582).
Please be sure to identify yourself as an
SDMS member and have your member
number ready.
It is important to note that coverage
availability is determined by the members’
state insurance commission.
New Member Scan
John Duncan recently
joined the SDMS and
is this month’s featured
member in the New
Member Scan. John
lives in Salem, Illinois is
married and the father
of two children, and
grandfather to one.
John and his wife, both
RNs, were previously
foster parents and
adopted their second
child. After retiring from a 31 year career in law
enforcement, with 12 of those years serving as the
Chief of Police, John attended Kaskaskia College
to attain his nursing degree. Since obtaining that
degree, he has been employed at Barnes Jewish
Hospital and also at VNA-TIP (a southern IL home
health care provider). John is currently taking a
hiatus from work, while attending sonography
school full time at Kaskaskia College. He describes
his attraction to sonography as stemming from a
desire to become more involved in the diagnostic
area of health care and his interest in computers
and science. John says he actually enjoys studying
the physics behind diagnostic ultrasound!
Having a deep interest in the science behind
sonography, John envisions many advances in
the next 10 years and already has seen some of
the innovations made with equipment, computer
algorithms, and sonographer techniques. Because
of his experiences, John believes that “Future
advances may only be bound by the laws of
physics and the imagination of the sonographer.”
John recognized the importance of a professional
organization that helps fashion standards of
practice and ethics. According to John, “these
are important if sonography is to be received as a
trusted and respected profession.” As a member
of SDMS, John hopes that it can provide him future
support in the areas of creating and maintaining
jobs, creating and maintaining professional
standards, continuing education, and political
lobbying in support of the profession.

SDMS News Wave February 2009 9
SDMS Answers Your Calls
SDMS shares its answers to our members’ most frequently asked questions!
How do I get FREE CME credit through
the Journal of Diagnostic Medical
Sonography (JDMS)?
Each issue of JDMS features at least one CME article and test. Members
can obtain FREE CME credit by reading the article and then successfully
completing a post-test online.
http://www.sdms.org/members/JDMS/default.asp
JDMS CME credits are available only to SDMS
members as an exclusive benefit of SDMS
membership.
The JDMS is now available online
through the SDMS website and provides
SDMS members with online access to
JDMS, the ability to search articles in
thousands of journals, and access to
MEDLINE and other resources.
http://www.sdms.org/members/JDMS/highwire.asp
.
SDMS makes every effort to provide superior customer
service to its members. If you have a question that you
would like featured in SDMS Answers Your Calls, please
email membercall@sdms.org
SDMS Member Benefit Change
SDMS has partnered with many vendors over the past years to provide members with
discounted and free CME opportunities. SDMS has decided to change its strategic
direction and no longer continue these types of agreements. The Society will instead
focus on developing free CME opportunities in-house. We have started by developing the
new SDMS Webinar Series (http://www.sdms.org/members/webinars/default.asp).
SDMS members can watch live or recorded webinars and complete a post-test for CME
credit. Best of all, it’s free to SDMS members.
SDMS would like to thank its partners, Echelon and Sonocredits.com for their support and dedication
to SDMS, its members and the sonography profession. Their dedication to providing quality continuing
medical education will continue to benefit the sonographer community.

SDMS News Wave February 2009 10
SDMS Product Spotlight:
Fire Sale!
Take advantage of these bargains
while they last! Quantities and/or
sizes may be limited.
Ordering is easy!
Call toll free 1-800-229-9506
Monday - Friday, 8 am - 5 pm (CDT)
or Fax your order to 214-473-8563
For our complete catalog, visit:
http://www.sdms.org/pdf/catalog.pdf

SDMS News Wave February 2009 11
SDMS Product Spotlight:
Ultrasound Physics ExamSim Suite CD-ROM,
2nd Edition
Frank R. Miele, MSEE
• Designed to provide
an efficient way of
preparing for the
Sonography Principles
and Instrumentation (SPI)
credentialing exam
• Delivers a customized study plan so you don’t
spend time studying material you already know
and a tutorial on test-taking strategies designed to
improve your test-taking skills
• A timed, full-length exam with 120 questions
accompanied by a patented analysis package
delivering hundreds of details as to your specific
areas of content strengths and weaknesses
Item #: 8030
CME credits: 16 SDMS CME credits or
13 AMA Category 1 credits
Price: $140.25 SDMS Member, $165.00 Non-member
Ultrasound Physics and Instrumentation,
4th Edition Self Instructional Program
Frank R. Miele, MSEE
• 7-week independent
learning course on physics
is designed to prepare
candidates for their national
certification exams on the
topics of ultrasound physics,
cardiovascular physics and/
or vascular physics
• Comes with an Animation and Image Library
CD-ROM that includes more than 300 videos,
animations and images
• Each chapter ends with a detailed key concepts
summary
• Contains over 1,300 questions with answers and
more than 600 images and figures
Item #: 7525
CME credit: 35 SDMS CME or
35 AMA Category l credits
Price: $127.50 SDMS Member, $150.00 Non-member
Join us this October at the Gaylord Opryland
Resort in Nashville, TN October 15-18, for
the 2009 SDMS Annual Conference! Relax at
the Relache Spa after lectures or take a Delta
Riverboat Tour through nine acres of indoor
gardens—and that’s just at the resort! Get out
and walk next door to the Grand Ole Opry,
take in a round of golf at Gaylord Springs or
take a ride on the General Jackson showboat.
Music City has never looked so good!
Save the Date – You don’t want to miss
THE sonographer event of the year!

SDMS News Wave February 2009 12
SDMS Welcomes New Members
January 2009
Bonnie Abenir BS, RDCS
Emery Brenner
Kelley Collier RN, RVT
Rachael Dollahon
Juan Acosta DO, FACOEP, FACEP
Diane Bricco MD, RVT
Holly Collison RDCS, RVT
Mary Dooley
Sophia Afshar
Shawna Bridwell
Michelle Connett RDMS
Kelly Dougherty RDMS
Chelsey Ahlers
Karen Brookshier RVT
Lidia Contreras
Joan Douglas MS, RDCS, RCS
Ami Arnette
Joni Brookshire RT(R), RDMS
Robyne Cooke
Carol Driebergen RT(R)(M), RDMS
Stephani Ash
Kari Brown RT(R)(M), RDMS
Michael Cooksey RDMS, RVT
Bonnie Dubij RVT
Thea Ashmead RDMS
Marlene Brown RDMS
JoAnn Cooper-Hunt
David Dunbar RT, RDMS, RDCS, RVT
Robert Atwater RDCS
Tiffany Brown RT(R), RDMS
Marlene Cornier
Kristy Dymond RDCS
Rochelle Axibal RDMS
Diana Browning
Beatrice Cornish RT(R)
Allison Ehrnschwender
Tracy Badertscher RT(R)(M), RDMS
Leah Bryant
Stephen Coy
Mariane Emodi
Kolee Bailey BS, RT(R)(CT)
Theresa Burke BS, RT(R)(CT), RDCS, LRT
Hannah Creech
Jennifer Erlandson
Elizabeth Ball RDMS
Stacy Burns
Cristal Cruz
Staci Eufemia RDMS
Marcy Barton
Hillary Burton
Alejandra Cuellar Oyaneder
Teresa Evick RT(R), RDMS, RVT
Sandra Bean BS, RDMS
Brittney Busellato
Sheena Cunningham
Pamela Falls RT(R)(N), RDMS
Suzanne Beaulieu RT(R), RDMS, RDCS
Myka Bussey-Campbell MEd, RT(R), RDMS
Jennifer Curran RT(R), RDMS
Brigit Farahan
Irene Becher RDMS
Marsha Camon
Karina Currie
Nancy Fetsko
Paulette Belaoula RDMS, RDCS, RVT
David Canfield
Jody Cyr RT(R), RDMS
Christi Flanagan RT(R), RDMS, RVT
Karen Belta RDMS, RDCS
Blanca Caro RDMS
Janice Dager RT(R), RDMS
Susan Fleming RT(R)
Christine Bencomo
Saul Carrasco RDMS
Stacie Dahl BS
Sandra Flowers RDMS
Dionne Benoit RDMS, RVT
Ophelia Carrillo
Nancy Dare RDMS
Zenobia Fountain RDMS, RVT
George Berdejo BA, RVT, FSVU
Pamela Carson RT(R), RDMS, RVT
Erik Davenport RCS
Michael Fox
Mary Berner RT(R), RDMS
Cecelia Cary RDCS, RCS
Tatiana Davidova
Thurston Frazier
Danielle Bertrand RT(R)(CT), RDMS
Cherri Cauldwell
Gail Davis RDCS
Jodi Friedberg RDMS
Louis Bianco
Linda Chapman RDCS
Sharyn Davis RN, RVT
Joey Fullilove RDMS, RVT
Mary Bihlmeyer RDMS
Krzysztof Charyk PhD, RDCS
Nancy Days RDMS
Jessica Gann
Pamela Bingham RT(R), RDMS
Kari Chau RDMS, RVT
Linda Dedvukaj RDMS
Julia Garcia-Montroy
Melissa Bjornson
Natalya Chernyak RDMS
Paul Dehn RDMS, RDCS, RVT
Susan Garrett
Roxanne Blacquiere RDMS
Shawanda Christy RDCS
R. Patrick DeMuth ThM, RVT
Jasmaine Gause
Julie-Anne Blom
Kanchan Chugh BS, RDMS, RDCS
Romi Derderian
Salomé Geene RVT
Rachel Bloom
Amy Chung-Thai
Kimberlie Dewey
Deborah Gelatt RDMS
Lance Boland BS
April Clarke RDMS
Sofia Dickey RDMS
Elizabeth Genin RT(R), RDMS
Kellie Bolanz RDMS, RVT
Karen Clarkson RDMS
Jeffrey Dierberger
Rhonda Genzer
Jacqueline Boling RT(R)
Elizabeth Cline RT(R), RDMS
Kathleen Dillon BA, RDMS
Maria George
Dawn Boyer RT(R), RDMS
Alan Cole RDMS
Simona Dinovo
Todd Gilbert RDCS
Christopher Brauer BS, RDMS, RDCS
Deanne Cole RDCS, RCS, RVS
Susan Diston RT(R), RDMS, RVT
Megan Girardin RT(R), RDMS

SDMS News Wave February 2009 13
Stephanie Girten RDMS
Aasma Jabeen
LeAnn Leydig RT(R), RDMS
Ebony Moses-Watson RT(R), RDMS
Caren Godak
Richard Jachimowicz RDCS, RVT
Charles Lloyd RCS
Reginia Mouton RT(R), RVT
Debra Goines BS, RT(R), RDMS, RVT
Brooke Jacobs
Tina Lockbaum RDMS
Georgina Murasso
Mary Gomes
Rita James RDCS
Kira Lockwood
Than Myint RDMS
Angeline Gomez
Irina Gorodetskaya RDMS
Chastity Green
Wendy Green RT(R), RDMS
Michael Gulledge RT(R), RDMS
Chad Hall RDMS, RDCS, RVT
Kevin Halow MD, RVT, FCCP, FACS
Barbara Hamilton RT(R)(M)(QM), RDMS,
RVT
Kimela Hardy MA, RT(R), RDMS
Dana Harp
Irene Harris
Susanne Harris RDMS, RDCS, RVT
Sylvia Hayes BS, RDMS
Angela Heffernan RDMS
Suzanne Heller RDMS
Megan Helveston RDMS
Timothy Henderleiter
Gwen Henderson
Amy Henry RDCS
Jamie Hibbitt
Eldon Hicks RT(R), RDMS, RVT
Sarah Hignite RVT
Jennilee Hockmeyer
Pamela Hodge RT(R), RDMS
Doreen Hodsdon RT(R), RDMS
Amber Holbrook
Teresa Holgate RDMS, RDCS
Ashley Holt BS, RT(R)
Kristen Holtzclaw RDMS
Carrol Hopkins
Jeff Hopkins
Hannah Horton
Lori Hyder MBA, RT(R), RDMS
Paul Inganamort RDMS, RVT
Linda James-Lambert BA, RT(R), RDMS
Brittany Jeffries RT(R)
Shawn Jenkins
Laurie Jensen
Kimberly Jeter
Carol Jones RVT, RDMS
Delores Jones
Nannette Jones RVT
Jessica Jorge
Ellen Julian
Gary Junker RDCS
Laura Juricak RDMS, RVT
Sheila Kaiser
Iman Kareem
Jenna Keating
Susan Keeton MS
Kresta Kessler RDMS
Phonesaat Khamly RDMS
Mohammad Khan MD
Inae Kim RDCS
Kayla Kimbrell
Terra Kingsmore RDMS
Edyth Klik
Fatima Klobocista RDMS
Tania Kozak Chubenko
Anne Krieger
Carol Lambright RDMS
Susan Landrum
Roberta Lange-Lifchez RDMS
Kathryn Lanter
Sharyl Larson RT(R)(M), RDMS
Mary Latrobe
Naiyma Lebrun
Lisa Lee RDMS
Alexandria Legott
Suzanne Loggins RT(R)(M), RDMS,
RDCS, RVS
Andrea Lombardo
Heather Lombardo
Tyler Longpre
Raquel Lorenzen
Daniel Lozano RT(R), RDCS
Hector Lujan RT(R)(CT), RDMS
Richard Lynn MD, RPVI, FACS
Jessie Magallanes RDMS
Michelle Maglonzo
Donna Maguire RDCS
Ravindra Malapur RDMS
Jenny Mancini
Iris Mandel RDMS, RDCS, RVT
Chelcie Martinez
Cassie McCoy
Dawn McCreight RDCS, RVS
Shirley McCurry RDMS
Maria McFee RDMS
Allyson McGuire
Angela McLoon RDMS
Bernard McNulty BS, RDCS, RVT
Margarita Mejia
Louise Mernick RDMS
Jill Merritt RDMS, RDCS, RVT
Samuel Meza RDCS
Enjoli Mezo
Randy Miller RCS, RVS
Sosena Million
Rachael Mills-Dudrey
Jacklyn Miranda
Michelle Mitev RDMS, RDCS
César Molano-Murillo RDMS
Stephanie Moore
Charlie Napiwocki RDCS, RVS
Charmaine Nathan RDMS
Jesse NeeSmith RDCS
Teresa Neiberg RT(R)(M), RDMS
Joy Nellen RDMS
Rose Ngo
Quyen Nguyen BS, RVT
Gail Nichols RDMS, RDCS
Eryn Nickell
Gisel Noa
Doneidre Noble
Lisa Nowak RT(R), RDMS, RVT
Trisha Oberg RDMS
Felicia Ochoa
Carol Oda
Raymond Olson RCS, RVS
Johnna Owecki
Rhonda Padgett RDMS
Amanda Paggen
Laura Pairot RDMS, RDCS, RVT
Isheeta Pancholi
Michelle Parrish RDMS
Surekha Patel MS, RT(R)(M), RDMS, RVT
Kerri Paxton RDCS, RCS, RVS
Anh Thu Pham RDMS
Heidi Pollard RDCS
Shelley Porter RDMS
Steven Poseley RDMS, RDCS, RVT
Susan Powell RT(R), RDMS, RDCS
Gloria Queriapa-Valdes
Dawn Radison
Sharan Rakalla-Lampe RT(R), RDMS
Gampala Reddy RDMS
Mary Redman

SDMS News Wave February 2009 14
Rebecca Reed
Shelly Seawel RDMS, RVT
Evelyn Stubing RDMS
Loret Waldal BS, RDMS, RVT
Mary Regan RT(R), RDMS
Kasey Seay RT(R)
Mary Sturm RDCS
John Walmsley RDCS
Lori Rehl RDMS
Christine Semens RT(R), RDMS
Eleni Tassopoulos
Rebecca Warren
Sumera Rehman RDMS
Debbi Shimozu RT(R)(M)
Alison Tedrick
Angela Watters RDMS
Candice Reithel RDMS
Alexander Shvedov
Kimberly Thomas
Elizabeth Webb
Amanda Rex
Lois Siewert RDCS
Tanya Thomas
Cindi Weber RDMS
Marisa Rhodes RT(R), RDMS, RVT
Cindy Singer RDMS
Ziffie Thomas RT(R)(M), RDMS
Janet Wencel BA, RDCS
Eva Richard RVT
Leah Skipper RT(R)
Abby Thomason
Patricia West RT(R), RDMS
Kristy Richter RDMS
Jacqueline Skrmetta
Ashley Thornsburg RT(R), RDMS
Andrea Westhusing RT(R)
Lydia Rivera RDMS, RDCS, RVT
Josephine Rizzo
Eric Rodriguez RDMS
Neal Rogers RDMS, RVT
Charissa Rojas
Tracie Rosecrans RT(R)
Felicia Russo RDCS
Susan Rutkowski RT(R), RDMS
Rachelle Ryan-Fabbrini BS, RT(R), RDMS, RVT
Karine Smith MD
Lindsey Smith RT(R)
Tiffany Smith RT(R)
Michelle Solecki RDMS
David Soltis BS, RT(R), RDMS, CRA
Karen Sopcic
Cynthia Soto
Gene Spain BBA, RDMS, RVT
Christopher Spears RDMS, RVT
Amy Tobin
Deepak Tolia MD
Stephanie Toney RDCS
Jamie Topp
Andrea Torgerson BS, RDCS
Elizabeth Torres RDMS
M. Carole Turcotte RDCS, RVT
Jessica Usua
Jessica Vale RT(R), RDMS
Diane Wheatley
Lauri Whitaker
Harry White BS, RT(R), RCS
Kelly Whitlock BS, RT(R), RDMS
Stephanie Whittington RDMS, RVT
Melanie Wiedeman
Rebecca Willis
Lindsay Wise
Mitra Sadigh
Jill St. Cyr RDMS
Geevarghese Valuthundil RT(R)
Athena Witt
Jane Saleeby
David Stanage RT(R), RDMS
Mary Van Matre
Jessica Witt BS, RT(R)
Nicole Salmon RT(R), RDMS
Stephanie Stang
Kathleen Varetoni RDMS
Janice Wolfe RT(R), RDMS
Aimee Sanfilippo
Richard Starrett MD, RVT, FHCS
Philip Vaughn
Tamara Wood RDMS
Sweta Sanghrajka RDMS
Michelle Steever
Jennifer Velez
Zina Wooten RDCS
Meena Sanghvi BS, RDMS, RVT
Amy Stephens RT(R), RDMS
Yilda Vidal RDMS
Robin Wright RT(R)
Francesca Schmitt RT(R), RDMS
Mary Stevens
Rachelle Vine RDMS, RDCS
May Yap
Kate Schneider
Carolyn Stewart BS, RVT
Anne Volante RDMS, RVT
Kristine Yates RDMS
Lillian Scholz RDMS
Nancy Storks RDMS, RVT
Joseph Vrablic RDMS, RVT
Kathryn Zale
Rheubin Scott RN, RVT
Lisa Strickoff RDMS, RDCS
Emily Waddell RT(R), RDMS
Genevieve Zamorano RT(S), RDMS
SDMS News Wave is archived online at:
http://www.sdms.org/members/NewsWave.asp
News Wave (ISSN 1541-7581) is published
to inform SDMS members of meetings,
events and policies as well as trends and
issues in the sonography profession. Please
send comments and suggestions to:
SDMS Headquarters
2745 N Dallas Pkwy Ste 350
Plano, TX 75093-8730
Phone: (214) 473-8057
FAX: (214) 473-8563
CEO and
Executive Director
Donald F. Haydon, CAE
Production Editor
Chris Alcott
All contents Copyright © 2009. All rights reserved by the Society of Diagnostic Medical Sonography, Plano, Texas.