Q: Does a physician need to be present when contrast is administered for an echo?
A: It is recommended that a physician be readily available, but it is not necessary for a physician to be present.
Q: Is it required to get written patient consent for the use of contrast?
A: Written consent is not necessary. Verbal consent (i.e. a discussion of indications, benefits, and potential risks), as with any medication given, is obtained; there is no need for specific documentation of this, unless your institution requires such documentation for all medications given (i.e. a UEA should be handled no differently).
A summary of best practices by various institutions can be found in the appendix of the 2014 sonographer guidelines update (located after the references).