Practice of Ultrasonography by nurses in obstetric nursing consultations

The number of complaints reporting the execution of ultrasound examinations by nursing professionals is increasing, especially for use in consultations, as a tool for qualifying care for pregnant women, for example. At the same time, there is a multiplication of training initiatives for midwives in carrying out ultrasound scans during nursing consultations, some of which are supported by the Federal Nursing Council – COREN. Although it is the competence of the nursing professional to analyze the patient under the aspects of nursing care, they are not allowed to perform or interpret imaging tests, nor are these professionals to carry out specialization and qualification courses in ultrasound. The examination, of any kind, that results in a diagnosis, is a medical act and as such must be performed and interpreted exclusively by the medical professional, based on article 4, item VII, of Law nº 12.842/2013, the Medical Act Law . Especially in relation to ultrasound, Resolution CFM 1361/92, in its article 1, prescribes that “It is the exclusive responsibility of the physician to perform and interpret the ultrasound examination in human beings, as well as to issue the respective report”. In fact, of all medical exams in radiology and diagnostic imaging, ultrasonography stands out for being entirely operator-dependent, in which images are produced and interpreted in real time, with the aim of diagnosis. In this sense, it is worth mentioning opinion 35/2017 of the CFM, which analyzed the possibility of performing the ultrasound by nurses and which expressly stated that the execution and interpretation of the ultrasound examination can only be performed by a physician, considering that the production of the real-time imaging usually leads to immediate action. In addition, considering that the Nurse cannot perform any interpretation, the execution of any exam without purpose exposes the patient to an innocuous act and, in most cases, can even be harmful to his health. It is not by chance that the Code of Medical Ethics, in its art. 14, expressly prohibits this conduct. Thus, in line with this understanding, the irregularity of the execution and interpretation of ultrasound exams by Nursing professionals is undeniable, including, obviously, the dissemination of training courses for the same professionals, and the medical community must denounce such activities, making enforce their legally guaranteed rights and prerogatives. CBR Legal Advice