Emergency Ultrasound Intern Rotation

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:
      • Ensure that all requests for days off and scheduled ED shifts are sent to Dr. Duran and Dr. Shannon prior to the start of the rotation.
  2.  ED Ultrasound Studies
    • Participants will obtain 150 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.  All Clinical Studies must be logged in the patient’s chart in EPIC as a Procedure Note and require visualization of images by the EM Attending in the area.
      • The ED POCUS workflow is outlined here.
    • If no clinically relevant scans are needed, the resident may complete exams for educational purposes on consenting patients.  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 and the Q-Path system.  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 ED 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 to view and curate their scans and submit them for QA.
    • Once submitted, scans will be reviewed by an US faculty for quality.
  3. Educational Content (Readings/Podcasts/Videos):
  1. 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.
  2. 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.
  3. 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.
  4. Ultrasound Guided Peripheral IV Access:  Residents are required to successfully complete the ED USGPIV training program which consists of the following:
  5. Trauma Center FAST Exams: Residents will be required to attend all trauma activations (be sure your pager will receive trauma alerts) during the day while on the US rotation and are required to perform the E-FAST exam for the Trauma Team.  The images must be shown to an Attending EM Physician and documented in the patient’s chart.  FAST exam performance will be assessed using a Standardized Direct Observational Tool (SDOTs) by an US faculty toward the end of the rotation.
  6. 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.
Deliverables:
At the end of the rotation please turn in the following to Dr. Duran or Debbie Eurom, her assistant:
  1. Ultrasound Scan Logs
  2. USGPIV pre-test, post-test, competency completion check off sheet
  3. ACEP Ultrasound Test printout