Emergency Ultrasound 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
    • Participate in Ultrasound 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 rotation.
  3.  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
      • GI (sbo, appy, etc.)
    • 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 at least 75% of the total number of scans required by ACEP guidelines (150 of 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 150 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, found on computers in ED and Resident Lounge) to view their scans and complete any reports not performed on the US machine.  Once completed, the scans will be reviewed by an US faculty for quality.
  4. Educational Content (Readings/Podcasts/Videos):
  5. Radiology Sonographer Scanning: On 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.
  6. Scan Rounds:  The resident will also 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.
    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.
  7. 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.
  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 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.
  10. 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)