2020-07-06 10:15:14 - 8

Errata: Official position of the CBR in defense of Ultrasound

CBR announces that, based on the note published on June 22 in its channels, such as the website and social networks, its hired Press Office produced a release to be disseminated among the communication vehicles. The text, however, was released with an error, in which it mentions that a regulation would be from CREMESP when the correct one is from COFEN. Therefore, it publicly apologizes to CREMESP for the error committed and for the inconvenience that this caused to the institution that fights for the same cause as the CBR, always in defense of the medical profession. CBR has already taken the necessary measures in relation to the company contracted to provide Press Office services, as well as already informed the communication vehicles that the news had repercussions about the wrong information. The vehicles in question have already republished the note, now with the correct information. The CBR makes itself available for any further clarifications deemed necessary. Below is the new text: Nursing is not qualified to perform ultrasound exams, says CBR repudiation note The Brazilian College of Radiology and Image Diagnosis (CBR), a national entity that officially represents the Specialty of Radiology in Brazil, issues a note of repudiation against the decision of the Federal Council of Nursing (COFEN), which authorizes the performance of ultrasound and issuance of reports by nursing professionals. According to the president of the CBR, Dr. Alair Sarmet Santos, carrying out ultrasound examinations, as well as issuing reports are medical acts, the results of which will guide the diagnosis and treatment of patients. “Training a professional to perform ultrasound takes time, involving knowledge that goes far beyond just learning the technique of how to perform an exam. Without discrediting the category, which is essential on other fronts, nursing is not qualified to perform this function. Ultrasound exams performed by professionals with poor training can lead to diagnostic failure or incorrect diagnosis. This COFEN regulation may jeopardize the safety of people who seek diagnostic investigation to continue their treatments', emphasizes the president. Check out the official CBR disclaimer here: CBR OFFICIAL POSITION IN DEFENSE OF ULTRASONOGRAPHY The Brazilian College of Radiology and Image Diagnosis (CBR), a national entity that officially represents the Specialty of Radiology in Brazil, by bringing together physicians who are specialists in Radiology and Image Diagnosis and those who use Ultrasound as their area of expertise, complying with their commitments and statutory obligations, makes public, before our associates, the medical profession, the entire Brazilian population and all national institutions, its REPUDIATION the decision pronounced in the judicial process that rejected the request for an injunction pleaded by the Regional Council of Medicine of the State of São Paulo (CREMESP), whose objective would be to revoke Resolution nº 627/2020 of the Federal Council of Nursing, to prevent professionals in this area from perform ultrasound examinations, as well as issue reports. We emphasize that this action was taken unilaterally by CREMESP, without having been consulted in order to provide greater technical subsidies, and it is an initial judicial decision, handed down in the seat of First Instance. Thus, it is still in the appeal phase, which should be done soon. The moment is critical and demands UNION from all of us in favor of good medical practice and the care that the Brazilian population deserves. For this reason, CBR reaffirms that it will make all its legal efforts, alongside the Federal Council of Medicine (CFM), to reverse this lower court decision, fulfilling its role in the scope of the Professional Defense of each physician it represents in the country. The National Ultrasonography Commission of the Brazilian College of Radiology and Image Diagnosis (CNUS/CBR) and our entire Board of Directors REPUDIATE The performance of ultrasound examinations by non-medical professionals, therefore, not qualified and/or qualified. We remind you that the training of a professional to perform Ultrasound takes time and there are already several very well specified norms that guarantee the QUALITY of the training of this medical professional, encompassing knowledge that goes far beyond just learning the technique of how to perform an ultrasound examination. This manifestation reinforces the position of the Technical Chamber of the Federal Council of Medicine (CFM) with the participation of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and CBR, edited in 2017, in opinion 35/2017, which reiterates that: "The execution and interpretation of an ultrasound examination, as well as the issuance of the respective report, are the exclusive competence of the physician. It is forbidden for the physician to delegate the performance of examinations to non-physicians and assume responsibility for an examination that he did not perform". Ultrasonography is a dynamic examination, whose documented images represent a minimal fraction of the multiplanar scans visualized by the physician during the examination and, therefore, insufficient, by themselves, to prepare a diagnostic report. Medical training enables knowledge of possible diagnoses and adequate direction of the examination. Therefore, CFM Resolution 2235/2019 ratifies opinion 35/2017 of CFM itself. As appropriate, we reiterate that the production of images in real time may lead to immediate action and, if not performed by a physician, may cause loss of time to resolve the case with a good result, which may generate a risk of irreversible damage to (the ) patient and increased maternal and perinatal morbidity and mortality. It should be noted that the previous CFM Resolution 1361/1992, dated December 9, 1992, already recognized the physician's exclusive competence in performing and interpreting ultrasound examinations in human beings, as well as issuing the respective report. A Law 12842 of the Medical Act, dated July 10, 2013, is explicit in its Article 4 on what are the exclusive activities of the physician in the following items: “III- indication of the execution and execution of invasive procedures, whether diagnostic, therapeutic or aesthetic, including deep vascular accesses, biopsies and endoscopies;” “VII – issuance of reports on endoscopic and imaging tests, invasive diagnostic procedures and anatomopathological tests”. Evaluating the facts, the Brazilian College of Radiology reaffirms its position in the sense that: - The indication, execution, interpretation and issuance of the Ultrasound exam report are the exclusive responsibility of the physician and that this is carried out by a trained professional and, preferably, with the proper certification by CBR/FEBRASGO/AMB. Despite the RESPECT that CBR has always had with the Nursing Councils (COFEN and CORENS), we reinforce that any type of news or content published by the Nursing Councils, stating that these professionals would be authorized to carry out ultrasound examinations and to issue reports and opinions on these images are about premature news, based on a legal decision at 1st instance, with the aim of disclosing untrue material, as they are in total disagreement with the Current legislation and it is in total disagreement with the rules of the Federal Council of Medicine, a body that has constitutional attributions of inspection and standardization of medical practice. We also remind you that any ultrasound performed by a professional who is not duly qualified may give rise to a PROCESS in the civil and criminal spheres, and that, of course, will be called a “MEDICAL ERROR”, and never a “nursing error” or any other professional in the area. of health! Finally, the CBR emphasizes that it will act legally to comply with Federal Law 12.842/2013, which clearly lists the activities that only doctors can perform, remembering that normative acts, such as resolutions and ordinances, issued by federal authorities, in this case in screen, Resolution No. 627/2020 of the Federal Council of Nursing, cannot and should not overlap with legal and constitutional provisions that deal with the matter. All appropriate measures are being taken in this regard, preserving the best care for the population, aiming at the safety of the patient, and in the case of obstetric Ultrasonography, of her fetus. The CBR is available to the entire medical and non-medical community for any clarifications deemed necessary. Dr. Alair Augusto Sarmet Moreira Damas dos Santos President of the Brazilian College of Radiology and Imaging Diagnosis