Emergency Ultrasound PGY3 Advanced Elective

Course Requirements:

  1.  Course Objectives:
    • Incorporation of point-of-care ultrasound into your daily practice of EM
    • Mastery of basic skills and the expansion of skills to include more advanced applications
    • Teach junior residents and medical students
    • Participation in POCUS system management, research, and QA
  2. Orientation:  Residents will meet with Ultrasound Faculty prior to, or on the first day of the rotation for further orientation to the US Advanced Elective.
  3.  Scan Rounds:  The resident will attend Ultrasound Rounds with an attending, which are usually scheduled 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.
  4. ED Ultrasound Studies
    • During their elective, participants will ensure that >250 ultrasound scans to cover all of the core emergency ultrasound applications have been submitted for QA via QPathE:
      • E-FAST
      • Renal
      • Gallbladder
      • Aorta
      • Pelvic (transvaginal and transabdominal)
      • Cardiac
      • Thoracic (lung)
      • Soft Tissue
      • DVT
      • Ocular
      • GI (sbo, appy, etc.)
    • Minimum requirements for views obtained are outlined here.
    • Following Wednesday a.m. QA scan review, residents are to report to the ED and identify themselves as on the US Elective.  They are expected to assist their peers working clinically by supervising any clinically relevant US examinations needed by the treatment team and ensuring appropriate workflow and documentation.  Workflow is outlined here: 
      • If no clinically relevant scans are needed, the resident may complete exams for educational purposes on consenting patients.  This process for Educational Scans is outlined here.
    • All images will be subject to the Emergency Department Ultrasound QA process for evaluation
      • Senior residents on elective are expected to produce enough images of acceptable quality to meet at least 75% of the total number of scans required by ACEP guidelines (150 of 250 required).

Educational Content (Readings/Podcasts/Videos):

  1. Emergency Ultrasound Journal Club:  The resident will also attend the monthly E-Journal Club meeting.  This meeting is held via webcast and can be accessed via phone app, computer or telephone.  Topic and article will be sent prior to event and must be reviewed prior to the JC to ensure resident participation.
  2. SonoSim:  Simulated Ultrasound Trainer
    • During your US rotation, you will be expected to complete the training modules available in the CSESaR Sim Center on the SonoSim laptop.  Your completion and scores will be part of your rotation evaluation.
    • The assigned modules will likely take a whole afternoon, and there is only one laptop console.  Please contact the SimCenter (Elizabeth.catoe@jax.ufl.edu or Joel.hart@jax.ufl.edu) one week prior to your US Block to schedule your time to complete the learning modules so there is no overlap with other learners.  Your loginid and password will be emailed to you by the SonoSim system.
      • PGY1 – Fundamentals of US, Cards, 1st Trimester Preg, Renal, EFAST, IVC, Bowel/Biliary, Ao/IVC
      • PGY2– Fundamentals of US, MSK, Ocular, RUSH, Pulm, Soft Tissue
      • PGY3 – Fundamentals of US, FOCUS/Advanced Cards, RUSH, EFAST, Ao/IVC (this is mostly catch-up for the next 2 years)
      • Peds Fellows – Fundamentals of US, EFAST, Soft Tissue, Renal, Bowel/Biliary,       MSK, 1st Trimester Preg, Pulm
  3. 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).   Complete each of the quizzes, and save your results/score page either as a pdf or a screen shot (if you don’t know how to download them), and email them to Debbie Eurom.  You can also print them all and place them on Dr. Duran or Dr. Shannon’s door by the end of the rotation.
  4. Heartworks TTE/TEE Cases: More to come on this simulator housed in CSESaR!
  5. Ultrasound Guided Peripheral IV Access:  Residents are required to successfully complete the ED USGPIV training program during their residency.  Check the Calendar of Events or the bulletin board in the ED Command Center for posted class times.  Alternately, email Jonathan Taunton (jonathan.taunton@jax.ufl.edu) to reserve a spot in one of the courses.  Prior to the course, complete the Pre-Test linked below and then watch the lecture.
  6. Intern/Medical Student Mentoring:  Senior residents will take an active role in teaching the Intern(s) and Medical Students during the rotation.  The Senior Resident will also assist in any skills lab teaching for the medical students during the rotation.
  7. US Case Report: Senior Elective 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 Bold City website as an EUS blogpost, presented in Conference, or submitted for publication. 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 Log sheets for out of department scans (if applicable)
  2. ACEP Ultrasound Test printouts (if not already completed)
  3. USGPIV competency check off sheet (if not already completed)
  4. Heartworks TTE/TEE case log
  5. EUS Case Presentation (submit elecronically as word document)