Anesthesia Basic Ultrasound Rotation
This is a 4 week rotation in emergency point-of-care ultrasound (POCUS).
The goal of this rotation is to provide you with the core knowledge base, bedside image acquisition/interpretation skill, and a framework for clinical integration to allow you to use bedside ultrasound in your daily Anesthesia/Critical Care practice.
During the block, residents will receive orientation to emergency ultrasound (EUS) including basic & advanced emergency EUS applications. The training sessions cover fundamental ultrasound physics, as well as diagnostic and procedural emergency ultrasound examinations and interpretations.
During orientation & the dedicated rotation, a combination of didactics, experiential learning and proficiency assessments will be employed. The following clinical ultrasound application topics will be covered with an emphasis on the applications in bold:
Trauma/EFAST
Intrauterine Pregnancy (transabdominal and transvaginal)
AAA
Cardiac/Volume Assessment
Biliary
Renal/Urinary Tract
DVT
Soft Tissue/Musculoskeletal
Thoracic/Airway
Ocular
Procedural Guidance
Bowel
We’ve included the ACGME Point-of-Care Ultrasound Milestones for Anesthesia Residents for your review.
CLINICAL EXPERIENCE AND SCHEDULE
Supervised scanning shifts - please refer to the Google calendar (linked here and under Rotation Logistics column above) for dates/times to meet faculty in the ED for bedside scanning and teaching. An Ultrasound faculty member will meet with you on the first day of the rotation for orientation and introductory scanning shift, please refer to the POCUS Calendar link to find out who/where/when to meet. As an adult learner, the rest of your time is independent and you must meet rotation requirements. After the first day you are expected to go to the OR for TEE/Nerve Blocks if nothing is going on in the ED, then meet up with the team for proctored scanning after.
Independent scanning shifts - during times when there is no scheduled supervised scan shift on the calendar, you are expected to be in the ED during weekdays obtaining as many cardiac, thoracic and procedural ultrasounds as possible. You should work closely with the EM2 on the rotation to maximize your experience, share contact information with each other and coordinate your scan shifts.
You’ll maximize your experience by joining POCUS faculty on their clinical shifts, they can help you find patients with good anatomy or interesting pathology to scan. POCUS faculty include: Dr. Wilson, Dr. Pope, Dr. Ho-Gotshall. The faculty shift schedule is posted on the low side cabinet of the GSED, you can also ask any of us on Thursdays.
Radiology tech scanning shifts - Tuesdays at Grand Strand & Wednesdays at South Strand from 4:30 - 7:00 pm. Please refer to the POCUS Google Calendar for the Ultrasound Technician you will be scanning with. We ask that you reach out to them the day of to confirm meeting time and place. Their numbers should be listed on the Calendar. You are responsible for communicating with the ultrasound technicians if you are not available to scan with him for any reason, but you are otherwise expected to be there. They are RDMS and RVT certified and can serve as your guide for abdominal and DVT studies.
Weekly education/QA meetings - these take place every Thursday at 9am in GME Building in Classroom 5. You must attend all Thursday meetings during your rotation, as well as your Anesthesia Didactics on Thursday afternoons.
You will be assigned a date to present a Journal Club style educational topic on the last Thursday of your rotation pertaining to POCUS. You can choose any topic that interests you, it may be based on an interesting case you encountered, the Fellows will help you in topic selection and presentation format. Ultrasoundgel.org is a great repository to start your search. You should email your journal article out to the POCUS team by Monday before your assigned Thursday date. We’ve covered topics such as Pnumonia, Nerve blocks, new FOAMed resources, Medical student and EMS education. Feel free to get creative!
REQUIREMENTS
1) CLINICAL
You can expect to GET OUT of this rotation, whatever you are willing to PUT IN. This is a low-stress time to hone your ultrasound-guided IV skills. You will GREATLY improve your skills if you take a couple of half days during this block to do nothing else except for practice placing these lines on ED patients (and the EM residents will love you for it). On days with unassigned activities, try and join POCUS faculty on clinical shifts, the more presence you have the more opportunities for procedures like paracenteses, thoracentesis, central lines, etc. If you do 5 ultrasound-guided IV’s in the month, you will probably not feel super confident in that procedure. If you do 40 or 50, you’ll start to learn tips and tricks and ultimately be much more successful. Easily said, the more you do, the better you will become.
Attend all THURSDAY education/QA meetings while on rotation.
2) READING/Education
Below are useful links with more educational resources:
5 Minute Sono – Core Ultrasound PLEASE WATCH: VTI/IVC, ultrasound-guided peripheral IV’s, every video under Pulmonary and every video under Cardiac
Highland EM Ultrasound Fueled pain management (highlandultrasound.com)
NYSORA - World Leader in Anesthesiology Education | NYSORA
3) ASSESSMENT
Complete the Core Ultrasound Curriculum including modules and quizzes. You should have received an invitation email titled "welcome to core ultrasound courses" where you will have to set up a username and password. Let me know if you have any issues logging in. You should complete the curriculum early in the rotation so you will have more time at the end to practice what you are learning.
CONTACT INFORMATION
First contact for rotation questions is: Jacob Pope, DO (Jacob_Pope@TeamHealth.com)