Point-of-Care Ultrasound (POCUS) or Real-Time Ultrasound (RTUS)
The College has received questions from chiropractic licensees about the use of point-of-care ultrasound (POCUS) or real-time ultrasound (RTUS) in clinical practice. POCUS or RTUS is a type of ultrasound technology that involves producing an image in real time.
When ultrasound is applied for diagnostic or imaging purposes, it is a restricted activity under the Regulated Health Practitioners Regulation. This restricted activity is not included in the scope of practice for chiropractors under the Complementary Health Professions Regulation. As a result, the use of POCUS or RTUS is outside the scope of practice for chiropractic licensees in British Columbia.
This is different from the use of therapeutic ultrasound as an adjunctive procedure. The College’s Scope of Practice Explanatory Statement: Chiropractic identifies therapeutic ultrasound as an example of an adjunctive procedure that is within scope of practice for chiropractic licensees.
The Scope of Practice Explanatory Statement provides the following guidance:
In-scope activities
Licensees may continue to use adjunctive diagnostic and therapeutic procedures that are in the public domain, provided they have the knowledge, skills and competence to perform the activity and the procedure is applied directly within their scope of practice. Examples include, but are not limited to, electrotherapies such as TENS and therapeutic ultrasound.
Out-of-scope activities
Licensees may not perform restricted activities that are outside their authorized scope of practice, including applying ultrasound for diagnostic or imaging purposes.
In practice: The use of POCUS or RTUS is outside the scope of practice for chiropractic licensees in BC. Therapeutic ultrasound may be used as an adjunctive procedure when you have the appropriate knowledge, skills and competence to perform the activity safely within your scope of practice.
For more information, see the College’s Scope of Practice Explanatory Statement: Chiropractic. If you have questions about whether a particular activity is within your scope of practice, contact a College Practice Advisor at practicesupport@cchpbc.ca.
