Emergency Ultrasound PGY3 Rotation

Senior Resident Ultrasound Rotation – The Rotation will focus on advanced ultrasound skills and improving workflow to integrate POCUS efficiently into a busy clinical practice
- The PGY3 Ultrasound experience takes place during the Block when residents are working clinically on the North Campus.
  - Every Wednesday and Thursday afternoon of the month, residents are expected to be present in the Clinical Center ED, actively scanning patients with the Ultrasound Division Faculty or supervising junior residents performing scans
    - Minimum requirements for views obtained are outlined here.
  - Wednesday a.m. is reserved for QA with Ultrasound Division Faculty; Thursday a.m. conference attendance remains mandatory.
  - ACEP Quiz completion and USGPIV credentialing must be completed if not previously done so.
  - Didactic curriculum not completed during the prior two ultrasound rotations must be completed.
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.
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PGY3 Curriculum – Critical Care ultrasound will be emphasized and expanded, including improving facility with advanced modalities such as spectral doppler and advanced cardiac and volume status applications.
- Advanced Cardiac & Resuscitation
  - 5-Minute Ultrasound – B-Lines ; 5-Minute Ultrasound – Tamponade ; 5-Minute Ultrasound – RV function ; 5-Minute Ultrasound – RV strain ; 5-Minute Ult rasound – 60/60 Sign for PE ; 5-Minute Ultrasound – Volume Responsiveness- LVOT VTI
  - Advanced Echo, Basics – Western Sono
  - Regio nal Wall Motion Abnormalities by Drs. Teran and Vanyo
  - Stroke Volume Assessment – Western Sono
- Advanced Lung:
  - Lung Slide beyond PTX – Western Sono
  - RebelEM POCUS for Pntx by Dr. Cirilli
  - Effusions: parapneumonic vs. atelectatic – Western Sono
  - 5-Minute Ultrasound – quantifying pleural effusions ; 5-Minute Ultrasound – pulmonary contusion ; 5-Minute Ultrasound – PE ; 5-Minute Ultrasound – Intubation
  - ARDS – Western Sono
  - Respiratory Failure Case
- Doppler
  - Doppler Basics – Ultrasound Podcast
  - Optimizing Doppler Settings – SonoWorld
- Torsions
  - Testicular, Part 1 – Ultrasound Podcast
  - Testicular, Part 2 – Ultrasound Podcast
  - Ovarian Torsion – Pearls and Pitfalls, RSNA, 2008
    - Ovarian Torsion and adenexae – Dr. Scoutt, SonoWorld
- GI Tract
  - 5-Minute Ultrasound – SBO ; 5-Minute Ultrasound – Pneumoperitoneum
  - AEUS – Appendix Ultrasound by Dr. Marla Levine and Dr. Lawrence Haines
  - AEUS – Pyloric Stenosis Ultrasound by Dr. Alexander Arroyo
  - AEUS – Pediatric Intussception by Dr. Samuel Lam
  - Small Bowel Obstruction by Drs. Avila and Whittle
- Supplemental reading on each topic can be found at the ACEP Sonoguideand any of the resources available in the Emergency Ultrasound Resources – Protected section of the Bold City website, particularly theEUS Manualand the SAEM Study Guides.
  - Additionally, two free E-books are available via iTunes for self-study:
    - Introduction to bedside Ultrasound: Volume 1, Dawson and Mallin
    - Introduction to Bedside Ultrasound: Volume 2, Mallin and Dawson
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.
  - ACEP Emergency Ultrasound Exam
  - Be careful, these questions can be tricky!
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, 1^st 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, 1^st Trimester Preg, Pulm
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.
Ultrasound Guided Peripheral IV Access: Residents are required to successfully complete the ED USGPIV training program. 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.
- USGPIV Pre-Test
- USGPIV Lecture
- Skills lab in the Sim Center (see Calendar of Events for scheduled dates and times)
- Post-test will be completed the day of the course after the skills lab
- 5 proctored USGPIVs per the USGPIV Competency Form
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.