Emergency Ultrasound Advanced Elective

Course Requirements:

  1.  Orientation:  Residents will meet with Ultrasound Faculty prior to, or on the first day of the rotation for further orientation to the US rotation.
    • Prior to the meeting, participants must review the following lectures and videos on the web:
    • As a Senior Resident, the goal of the rotation should be to incorporate point-of-care ultrasound into your daily practice of EM.  Therefore, focus should be on a mastery of basic skills and the expansion of skills to include more advanced applications.
  2.  ED Ultrasound Studies
    • Participants will obtain 250 ultrasound scans to cover all of the core emergency ultrasound applications:
      • E-FAST
      • Renal
      • Gallbladder
      • Aorta
      • Pelvic (transvaginal and transabdominal)
      • Cardiac
      • Thoracic (lung)
      • Soft Tissue
      • DVT
      • Ocular
    • Residents are to report to the ED and identify themselves as on the US rotation, performing any clinically relevant US examinations needed by the treatment team.  If no clinically relevant scans are needed, the resident may complete exams for educational purposes on consenting patients.  All clinically relevant scans must be logged in the patient’s chart and require visualization of images by the EM Attending in the area.  Educational scans do not require an attending over read or EMR documentation.
    • All images will be subject to the Emergency Department Ultrasound QA process for evaluation.  Participants are expected to produce enough images of acceptable quality to meet the total number of scans required by ACEP guidelines (250 required).
    • Scans are tracked using Scan Logs.  Be sure to place a sticker on your log page and check off all scans performed.  Scan Logs are to be turned in at the end of the rotation.
    • Ultrasounds performed outside of the Emergency Department will count toward the 250 goal as long as they are logged on the scan log and signed off by a preceptor.
    • Participants are required to log into the Image Storage/QA system (Q-Path) to view their scans and complete any reports to submit for QA.  Once completed, the scans will be reviewed by an US faculty for quality.
  3. SonoSim:  The SonoSim program provides both educational didactics via an interactive web course and case based ultrasound exam simulation.
    • Didactic interactive lectures require log in, which you will be sent at the start of the rotation.
      • Complete the following educational modules:
        • Intestinal/biliary
        • Soft Tissue
        • MSK
        • Pulmonary
        • RUSH
    • Ultrasound exam simulation cases are to be performed in the Simulation Center (CSEASAR) once the didactic modules are complete.  Use your log in to complete cases 1-7 as practice and then complete case 8-10 in TEST mode and save the images.
      • Complete the following educational modules:
        • Intestinal/biliary
        • Soft Tissue
        • MSK
        • Pulmonary
        • RUSH
    • Review the Sonosim Quick Start videos for program orientation prior to use.
    • Contact the Simulation Center: CSEASAR (Liz or Joel, 244-1120 or 244-1116) before going over to ensure that someone can unlock the room with the simulator.
  4. Further Reading:  In addition to the SonoSim lecture modules, residents will also be required to view the following lectures:
  5. ACEP Ultrasound Test: 
    • Participants will be required to complete and pass all 12 sections of the online Emergency Ultrasound Exam created by the American College of Emergency Physicians (ACEP) and print the passing certificate to turn in at the end of the rotation.
  6. Radiology Sonographer ScanningOn Tuesday mornings the resident will report to Candiss DeJesus, Ultrasound Supervisor, in the ultrasound department in Radiology at 9am to scan with an ultrasonographer.  All scans performed should be documented on the resident’s Scan Log and be signed off by the sonographer.
  7. Scan Rounds:  The resident will also attend Ultrasound Rounds with an attending on Wednesday mornings at 9am.  We will discuss ultrasound topics, answer questions, review scans performed in the previous week and then go around the department to scan any interesting cases.
  8. Intern/Medical Student Mentoring:  Senior residents will take an active role in teaching the Intern(s) and Medical Students during the rotation.  The SeniorResident will also assist in any skills lab teaching for the medical students during the rotation.
  9. Ultrasound Guided Peripheral IV Access:  Residents are required to successfully complete the ED USGPIV training program which consists of the following:
  10. Ultrasound QA: Senior residents are required to review and complete QA forms on 25 ultrasound studies performed by their peers.  The resident will be given the scans during the last week of their rotation and the images may NOT leave the campus due to HIPPA compliance.  QA reports must be turned in by the end of the rotation.
  11. US Blog Case: Participants are required to write up a case that was either interesting, unique, unexpected or had an important teaching point based on one of their ultrasound cases from the month.  The write up must have two components: the initial case presentation with ultrasound images and the results of the case with a review of the literature and teaching points about the relevant findings in the case.  This case will be posted on the US Blog as one of the weekly cases and the resident will receive credit for the presentation

Deliverables:

At the end of the rotation please turn in the following to Dr. Duran, Dr. Shannon or Debbie Eurom, their assistant:

  1. Ultrasound Scan Logs
  2. UltraSim Cases
  3. ACEP Ultrasound Test printout
  4. QA Reports
  5. US Blog Case Presentation (submit elecronically as word document)