PGY-2 Ultrasound Elective A

Course Directors

Emergency Ultrasound Director: Dr. Leila L. PoSaw, MD

Assistant Program Director, EM Residency Program: Dr. Patricia Panakos, MD

Goal

The fundamental goal of this elective is to provide an opportunity for PGY2 residents to develop and advance their knowledge, attitude and skills in point-of-care ultrasound practice, administration, research and teaching.

Objectives

By the end of this elective, PGY2 residents will be able to:

1. Demonstrate technical skills in the application of POCUS to critical illness, cardiac arrest, TEE, contrast enhanced US and regional nerve blocks.

2. Identify minimal imaging criteria and describe the process of quality assurance.

3. Critically evaluate current POCUS literature and demonstrate scholarly writing.

4. Demonstrate the process of developing a brief, focused training program for a group of learners.

Pre-requisites

Required: PGY1 US Rotation. Recommended: PGY2 US Rotation.

Course Calendar

Duration: 2-4 weeks. Monday-Friday: 830-1630. Total anticipated hours per week (including study time): 60 hours. No overnight or weekend call.

Suggested Reading (Calder Library eBooks)

a.Atlas of Ultrasound-Guided Regional Anesthesia, Third Edition. (Andrew T. Gray)

b.Critical Care Ultrasound (Lumb/Karakitsos)

c.Ultrasound: The Requisites (Hertzberg/Middleton)

Grading

Pass/Fail

Educational Strategy

Design - In this elective, PGY2 residents will learn advanced POCUS - practice, administration and research. They will be given the opportunity to design their curriculum with choices from A and B, C and/or D.

A. US practice: The application of POCUS to cardiac arrest, critical illnesses, TEE, contrast enhanced ultrasound, regional nerve blocks.

B. US administration: An understanding of the quality assurance process and machine maintenance.

C. US research:

(a) The critical evaluation of current POCUS literature, and

(b) writing a brief scholarly article.

D. US teaching: The development of a 2-hour US training session for a targeted group of learners.

Methods

A. US practice

a. ED Scanning:

1. On Mondays-Fridays, 0830-1630, the resident will be on call to the JMH ED by Spectralink phone, 8744.

2. Attend all cardiac arrests and/or sepsis alerts (code yellow).

3. Perform USG procedures (central lines, peripheral lines, paracentesis, lumbar punctures, thoracentesis, arterial lines etc.) Suggested time: 3 hours/day.

b. Transesophageal Echocardiography:

1. Practice simulated training on the Vimedix model at the Patient Safety Institute. A TEE training schedule is available (Contact: Ilya Shektar). Suggested time: 2 hours/week.

2. Observe TEE performed by the cardiology fellow. Information is available from the cardiology department (Contact: Naomi Melendres). Suggested time: on call.

c. Transthoracic Echocardiography:

1. Observe contrast enhanced ultrasound performed by the cardiology echo tech. (Contact: Naomi Melendres). Suggested time: 4 hours/2 weeks.

2. Read echocardiograms with the cardiology echo team. (Contact: Naomi Melendres). Suggested time: 4 hours/2 weeks.

d. Nerve Blocks:

1. Theoretical discussion on nerve block indications and techniques.

2. Practical training may be available. Suggested time: 4 hours/elective.

B. US administration:

1. Perform quality assurance on Q-path with US Faculty. Suggested time: 1 hour/week.

C. US research:

1. Critically evaluate POCUS articles: 5/week. Suggested time: 4 hours/week.

2. Write a scholarly article. Suggested time: 8 hours/week.

D. US teaching:

1. Design a brief course and train a selected group of learners. Suggested time: 12 hours/week.

Evaluation

A. US practice:

• Minimum number of targeted scans per week: 25.

B. US administration:

• Demonstrate engagement in the QA process: 1 hour/week.

C. US research:

• Present/discuss articles on selected US topics: 5/week.
• Write a brief, scholarly article on selected POCUS topic.

D. US teaching:

• Design, organize and teach a 2-hour course on a POCUS topic to a selected group of learners.