delivering training in ultrasound
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Core Ultrasound Skills in Intensive Care
PHASE 1: Initial theoretical and practical trainingE-learningCourse
PHASE 2: Supervised practice until competence demonstrated in acquiring and saving images
PHASE 3: Mentored practice with completion of log book demonstrating knowledge of an appropriate range of pathology
PHASE 4: Completion of competency assessments within the range of practice
http://www.e-lfh.org.uk/programmes/icu-echoultrasound/sample-session/
ModalitiesEchocardiography
Focused Intensive Care Echocardiography (FICE)
British Society of EchocardiographyLung Ultrasound
BLU Protocol(British Thoracic Society)
Abdominal Vascular
ECHOCARDIOGRAPHY
Focused Intensive Care Echocardiography (British Society of Echocardiography) 10 scans under direct supervision Logbook with 50 (suitable) cases Triggered assessment
FICE scans5 Views
Parasternal long axis Parasternal short axis Apical 4 chamber Subcostal Pleural fluid
6 questions Is LV significantly impaired? Is LV dilated? Is RV significantly dilated or
impaired? Is there pericardial fluid? Is there evidence of
hypovolaemia? Is there pleural fluid?
LUNG BLU protocol 50 scans (no more than 10 normal) Ultrasound-guided pleural
aspiration and drainage Triggered assessment
ABDOMINAL Recognition of US
appearance ofbowelliverspleenKidneys
(eFAST and AAA) Assessment and drainage
of ascites
VASCULAR Real-time Short and long axis No minimum number CVC Sites
Internal Jugular Femoral (Subclavian)
Training the trainerModules will evolve
Other US modalitiesReaccreditationMaintain your skills
Life long learning
To deliver high quality US training, you need…
Clear objectives
Brilliant faculty and colleagues
Do it properly
Further information/reading Expert Round Table on Ultrasound in ICU, Cholley B et al (2011)
International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37:1077–1083
Intensive Care Society UK CUSIC Accreditation - http://www.ics.ac.uk/ics-homepage/accreditation-modules/cusic-accreditation/
Online resources #POCUS - twitter
Oxford Point-of Care Ultrasound Programme [email protected], [email protected] @avkwong