Emergency Medicine - US

The Center of Ultrasound Education in conjunction with the Emergency Medicine Residency is proud to offer an integrated ultrasound curriculum as part of your training. This curriculum will consist of didactic training, hands-on ultrasound scanning labs and scanning rounds, and proficiency assessment and tracking. The goal is for every resident to have access to Point-of-Care Ultrasound training and the opportunity to develop life-long skills to advance their medical practice.

UltraSound Transducer Preparationencounter-based workflow using exoworks

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Ultrasound lecture dates and topics:

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July: INTRO CLINICAL ULTRASOUND / FAST EXAM

August: SOFT TISSUE/LYMPH NODES

September: ULTRASOUND GUIDED PROCEDURES 

October: AORTA/KIDNEYS

November: PEDIATRIC POCUS

December: GALLBLADDER - LIVER/BILIARY

January: CARDIAC INTROORIENTATIONOPTIMIZNG WINDOWS

February: OB US 

March: THORACIC 

March: LE VASCULAR/OCULAR

May: RUSH EXAM

June: POCUS competency TEST

IMPORTANT RESOURCES

Curriculum: Each month the ultrasound curriculum will focus on a specific POCUS exam. This exam will be the focus of the online as well as in-person didactic lectures and scanning sessions. You will have a greater understanding of the topic of the month if you view the online didactic material before the scanning session.

 

Competency POCUS Exams: During your residency, you are expected to achieve competency in performing, interpreting, and clinically integrating the POCUS exams below:

1. FAST Exam
2. Evaluation of the Heart and IVC (Shock Assessment and RUSH Exam)
3. Evaluation of the Aorta
4. Evaluation of the 1^st & 3^rd Trimester OB Patient
5. Evaluation of the Thorax
6. Ultrasound Guided Procedures (US guided needle placement)
7. Evaluation of the Lower Extremity veins
8. Evaluation of the Gallbladder

 

 Assessments:  Each June, you will be tested on your ultrasound skills with an online test and an in-person ultrasound practicum. The practicum will include testing on ultrasound knowledge as well as scanning ability.

 

Scanning Sessions: Each month there will be open scanning sessions in the Center for Ultrasound Education (CJ3101 – Pavilion 3). These sessions will have instructors and ultrasound models for you to scan to improve your image acquisition skills. During these sessions, we will review the key components of the ultrasound exam of the month. You are expected to attend these sessions if you are not working clinically. These sessions give you an opportunity to ask questions and practice your skills.

 

Scanning Numbers:  EXOWORKS will be used to calculate your scanning totals each year.  Please be aware that the attending you are working with must have signed off on the scan (either clinical or educational) for you to receive credit.  You are allowed to submit ultrasounds obtained on ICU electives and during scanning sessions in the ultrasound center in your Qualtrics procedure logs.  Scans done in the ED (including scans for procedure scans) should not be documented in Qualtrics.  For example  - if you perform an arterial line in the ED – you need to capture and submit an image in EXOWORKS to receive credit for the ultrasound.  You will also document the A line procedure on your personal log to receive credit for the procedural portion.

 

If the ultrasound scan is for education, follow the Educational Ultrasound Guidelines below.

• Ultrasound exams cannot be used for medical decision making.
• Educational scans may not be done on patients with complaints related to the exam (e.g. an educational FAST exam may not be done on a trauma patient or an educational gallbladder ultrasound may not be done on a patient with right upper quadrant pain). The exception is that an education ultrasound exam related to the patient’s complaint may be done if a complete study (CT scan or an ultrasound exam performed by Radiology) has already been done or will be done after the educational ultrasound exam. Educational exams may be done unrelated to their medical complaint (e.g. a gallbladder ultrasound exam can be done on a patient with pneumonia).
• The patient must be informed that the ultrasound exam is for educational purposes only and that they will not be charged for the exam and the results will not be placed in the patient’s medical record.
• Permission must be given by the patient for the scan. (Guidelines Subject to Revision)

 

POCUS Proficiency Pathway: The purpose of this pathway is to provide graduating residents documentation of POCUS skills at the end of GME training that can be used for hospital and practice credentialing of skill. This pathway is currently optional (subject to change based on residency leadership -please refer to residency handbook for definite guidance on US graduation requirements) All requirements listed in the document below are mandatory to obtain the certification.

 

 POCUS Proficiency Pathway Proficiency Certification Requirements

 

Ultrasound Machines: Almost any ultrasound machine can be used for educational ultrasound practice.  Only the machines in the ED are linked directly to EXOWORKS currently.  If you use other machines in the hospital (MICU, STU, CCU, PICU) you will need to log these scans on your personal Qualtrics log.  If you want to borrow a Lumify system for practice, you can sign out a machine from Ultrasound Center.