Emergency Ultrasound Intern Curriculum

Course Requirements:

  1.  Intern Ultrasound Experience:
  2.  ED Ultrasound Studies – Graduation Requirements
    • During residency, it is expected that approximately 250 scans will be performed, covering all of the core emergency ultrasound applications.  A benchmark goal is to have completed 150 ultrasound scans during the first year.
      • E-FAST
      • Renal
      • Gallbladder
      • Aorta
      • Pelvic (transvaginal and transabdominal)
      • Cardiac
      • Soft Tissue
      • DVT*
      • Ocular*
      • Procedural*
      • Thoracic*
        • * These studies will be emphasized during the PGY2 curriculum
  3. ED POCUS Workflow is outlined below
  • 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 responsible for care.  If a scan is being performed for educational purposes only and is found to be normal, no Attending over-read or EMR documentation is indicated.  However, the Pt must be able to provide informed consent for education scans.  Recommendations for consenting patients are reviewed.

  • All images will be subject to the Emergency Department Ultrasound QA process for evaluation.  Interns 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).
  • Minimum requirements for each view are outlined here
  • Scans are tracked using Scan Logs and the Q-Path system.
    • Q-Path is found on computers in the ED, Resident Lounge, and via VPN if you contact Debbie Eurom for the link.  Once submitted, scans will be reviewed by an US faculty for quality.
    • Ultrasound scans performed outside of the ED (e.g. OB, ICU, etc.) will count toward the 250 goal as long as they are logged on the Scan Log and signed off by a preceptor.  Be sure to place a patient sticker on your log page and check off all scans performed.  Scan Logs are to be turned in to Debbie Eurom in the ED office.
  • Q-Path – Participants are required to log into the image storage/QA system to view and curate their scans and submit them for QA.  Please review how to do so below.

Educational Content (Readings/Podcasts/Videos):

  1. ACEP Ultrasound Test: 
    • Participants will be required to complete and pass all assigned sections of the online Emergency Ultrasound Exam created by the American College of Emergency Physicians (ACEP).  These include Physics, Cardiovascular, Urinary Tract, Trauma, Soft-Tissue, Biliary, AAA, Procedural and First-Trimester Pregnancy.   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.
  2. Scan Rounds:  Ultrasound QA Rounds are scheduled on Wednesday mornings at 9am.  We will discuss ultrasound topics, answer questions, and review scans performed in the previous week.  Depending on the make up of the team, we will then perform supervised scanning in the ED, with an emphasis on new applications or interesting cases.
  3. 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
  4. Ultrasound Guided Peripheral IV Access:  Residents are required to successfully complete the ED USGPIV training program.  If the Intern USGPIV session is missed, you must schedule a make-up session– 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.  The course consists of the of the following:
  5. 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 for studies outside the Department
  2. USGPIV pre-test, post-test, competency completion check off sheet
  3. ACEP Ultrasound Test printouts