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Section H
Equipment Chart
Facility Name: _____________________________________
1. Describe all Ultrasound units in use by facility being reviewed in the accreditation process by completing the blanks. If necessary, copy this page, if more space is
needed for additional units.
Total number of units in this US facility (this geographic location) applying for ACR accreditation: __________
Unit #
Name of Manufacturer
Model Type
Year Manufactured
sample Equip. make, M36, '92
1.
GEM,RT3200 ADV3,'91
2.
3.
4.
5.
6.
7.
8.
9.
10.
*Place X in the appropriate box if the ultrasound unit has this feature.
**In the appropriate box, indicate the number of transducers of each type and frequency utilized with this unit. If a transducer is used with more than one machine list only once.
***Place in the box the appropriate number(s) to show recording system(s) used with each unit. 1. Multiformat camera 2. Laser camera 3. Thermal paper printer 4. Polaroid
5. Videotape 6. Color printer 7. Digital storage. Units not used to acquire images are subject to onsite inspection or random film checks.
Key: Acuson (ACU), Acoustic Imaging (ASO), Ausonics (AUS), Diasonics (DIA), GE Medical Systems (GEM), Hewlett-Packard Co. (HEW), Hitachi Medical Corp. (HIT),
Phillips Medical Systems (PHI), Shimadzu Medical Systems (SHI), Siemens Medical Systems (SIE), Thomson Components and Tubes Corp. (THO), Toshiba America
Medical Systems (TOS0, ATL (ATL)
ACR US Accreditation Application 2/96
TRANSDUCERS*
Phased Array
Biopsy
Spec-
C
2-3.5
5-7.5
Guide
Tral
o
mHz
mHz
l
Dop-
o
pler
r
X
X
1
1
Linear &
Mechanical Sector
Curvilinear Array
>7.5
2-3.5
5-7.5
> 7.5
2-3.5
5-7.5
mHz
mHz
mHz
mHz
mHz
mHz
1
2
1
2
ACR UAP Id No. _____________
Endovaginal
Endorectal Other
> 7.5
3-5
>5
3-5
>5
mHz
mHz
mHz
mHz
mHz
1
1
1
Recording
System
1,5,6
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