scholarly journals LO090: Introduction of a formalized RUSH (Rapid Ultrasound in Shock) protocol in emergency medicine residency ultrasound training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S61-S61
Author(s):  
C. Hrymak ◽  
C. Pham
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Educational Module ◽  
Ultrasound Education ◽  
Didactic Teaching ◽  
Video Clips ◽  
Simulation Based ◽  
Hands On ◽  
Future Direction

Introduction / Innovation Concept: Expanding point of care ultrasound education in emergency medicine (EM) programs is a necessary part of curriculum development. Our objective was to integrate core and advanced applications for point of care ultrasound in caring for critically ill patients with undifferentiated shock. We chose to develop and implement an educational module using the systematic approach of the RUSH Exam for EM residents in our institution. Methods: After review of the literature in point-of-care ultrasound, a module was designed. An educational proposal outlining the RUSH Exam training within the -EM and CCFP-EM curricula was submitted to and accepted by the residency training committee. The objectives and goals were outlined in accordance with CanMEDS roles, and the ultrasound director provided supervision for the project. Curriculum, Tool, or Material: An 8-hour educational module was implemented between October 7 and November 18, 2014. All residents received formal training on the core applications in FAST and aortic scans prior to implementation. The following components of the RUSH Exam were included: two hours of didactic teaching with video clips on advanced cardiac, IVC, DVT, and pulmonary assessment; three hours of hands-on practice on standardized patients performed in the simulation lab to practice image acquisition and interpretation; one hour of didactic teaching on the overall approach to a patient with undifferentiated shock using the RUSH Exam; and two hours of hands-on RUSH Exam practice. A corresponding research project integrating a SonoSim Livescan training platform, a simulation-based testing device, demonstrated improvement in resident performance, subjective comfort with imaging patients in shock and making clinical decisions based on the findings. Conclusion: This 8-hour RUSH Exam educational module combined theoretical learning and hands-on practice for trainees. This module significantly broadened the scope of ultrasound training in our curriculum by providing the necessary skills in approaching patients in shock in a systematic fashion. Future direction will include ongoing education in this area and expansion as appropriate.

scholarly journals LO092: The educational impact of a formalized RUSH (Rapid Ultrasound in Shock) protocol in emergency medicine residency ultrasound training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S61-S62
Author(s):  
C. Hrymak ◽  
E. Weldon ◽  
C. Pham
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Image Acquisition ◽  
Image Interpretation ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Educational Impact ◽  
Hands On ◽  
Before And After ◽  
Junior Residents

Introduction: Point of care ultrasound for assessment of undifferentiated hypotension and shock is part of the clinical scope of Emergency Physicians in Canada. The RUSH Exam outlines a systematic approach to these patients. A RUSH Exam educational model using didactic and hands on practice was developed and implemented for Emergency Medicine (EM) residents. This study evaluated the effectiveness of the module in a simulated setting on the following endpoints: improvement in image acquisition, interpretation, speed, and subjective comfort level, among EM residents with basic ultrasound training. Methods: Approval was received from the institutional health research ethics board for this before and after simulation study. Residents in the -EM Program or CCFP-EM Program from July 2014 to July 2015 were eligible to consent. Participants were excluded if they were unable to complete all portions. All residents were educated to the same level of introductory ultrasound training based on the curriculum in place at our institution. The 8-hour intervention included RUSH didactic and hands on small group sessions. Testing before and after the intervention was performed with the SonoSim Livescan training platform. Two evaluators scored each resident on the accuracy of image acquisition, image interpretation, and time to scan completion. A before and after survey assessed resident comfort level with performing ultrasound on an emergency patient in shock, and basing decisions on ultrasound findings. Statistical analysis was performed using McNemar’s test for image acquisition and interpretation, a paired T test for time, and the Bahpkar test for the questionnaire. Results: 16 EM residents including 11 senior residents and 5 junior residents were enrolled. Improvement was achieved in the categories of IVC image acquisition and interpretation, as well as interpretation for B-lines, lung sliding, cardiac apical and parasternal long axis, and DVT (p<0.05). Subjective comfort level of performing ultrasound in shock and basing decisions on the findings was increased (p<0.0001). Among junior residents, there was an increased speed of image acquisition. Conclusion: With the introduction of the RUSH Exam educational module, EM residents showed improved image acquisition, image interpretation, speed, and comfort level when using ultrasound in critically ill patients.

scholarly journals National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs

2021 ◽  
Vol 22 (5) ◽  
pp. 1095-1101
Author(s):  
Stephen Alerhand ◽  
Elaine Situ-Lacasse ◽  
Christine Ramdin ◽  
Michael Gottlieb
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Survey Study ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
The Past ◽  
Current Prevalence ◽  
Hands On

Introduction: Residency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM). Methods: This was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track. Results: Of 267 residency programs 199 (74.5%) completed the survey. Fifty-seven (28.6%) had a POCUS scholarly track as of the 2019-2020 academic year. Scholarly tracks in POCUS were more common in university-based/academic sites and larger residency programs. Of the 57 programs with POCUS scholarly tracks, 48 (84.2%) required residents to present at least one POCUS lecture, 45 (78.9%) required residents to serve as instructor at a hands-on workshop, and 42 (73.7%) required residents to participate in quality assurance of departmental POCUS scans. Only 28 (49.1%) tracks had a structured curriculum, and 26 (45.6%) required POCUS research. In total, 300 EM residents completed a POCUS scholarly track over the past three academic years, with a median of 4 (2-9) per program. Seventy-five (25.0%) proceeded to a clinical ultrasound fellowship after residency graduation, with a median of 1 (interquartile range 0-2) per program. A total of 139 POCUS-specific abstracts (median 2 [0-3]) and 80 peer-reviewed manuscripts (median 1 [0-2]) were published by scholarly track residents over the past three years. Conclusion: This survey study describes the current prevalence, characteristics, and outcomes of POCUS scholarly tracks across EM residency programs. The results may inform the decisions of residency programs to create these tracks.

scholarly journals Use of a Refresher Course Increases Confidence in Point-of-Care Ultrasound Skills in Emergency Medicine Faculty

Cureus ◽  
2019 ◽  
Author(s):  
Madeline Schwid ◽  
Owen Harris ◽  
Adaira Landry ◽  
Andrew Eyre ◽  
Patricia Henwood ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound

Perception of point-of-care ultrasound performed by emergency medicine physicians

2017 ◽  
Vol 45 (7) ◽  
pp. 408-415 ◽  
Author(s):  
Whitney Hansen ◽  
Carl E. Mitchell ◽  
Bikash Bhattarai ◽  
Napatkamon Ayutyanont ◽  
Jeffrey R. Stowell
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound

Barriers to reporting guideline adherence in point-of-care ultrasound research: a cross-sectional survey of authors and journal editors

2021 ◽  
pp. bmjebm-2020-111604
Author(s):  
Ross Prager ◽  
Luke Gagnon ◽  
Joshua Bowdridge ◽  
Rudy R Unni ◽  
Trevor A McGrath ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Peer Review ◽  
Review Process ◽  
Response Rate ◽  
Peer Review Process ◽  
Point Of Care ◽  
Reporting Quality ◽  
Point Of Care Ultrasound ◽  
Research Reporting ◽  
Journal Editors

ObjectiveAlthough the literature supporting the use of point-of-care ultrasound (POCUS) continues to grow, incomplete reporting of primary diagnostic accuracy studies has previously been identified as a barrier to translating research into practice and to performing unbiased systematic reviews. This study assesses POCUS investigator and journal editor attitudes towards barriers to adhering to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines.Design, setting, participantsTwo separate surveys using a 5-point Likert scale were sent to POCUS study investigators and journal editors to assess for knowledge, attitude and behavioural barriers to the complete reporting of POCUS research. Respondents were identified based on a previous study assessing STARD 2015 adherence for POCUS studies published in emergency medicine, anaesthesia and critical care journals. Responses were anonymously linked to STARD 2015 adherence data from the previous study. Written responses were thematically grouped into the following categories: knowledge, attitude and behavioural barriers to quality reporting, or other. Likert response items are reported as median with IQRs.Main outcome measuresThe primary outcome was the median Likert score for the investigator and editor surveys assessing knowledge, attitude and behavioural beliefs about barriers to adhering to the STARD 2015 guidelines.ResultsThe investigator survey response rate was 18/69 (26%) and the editor response rate was 5/21 (24%). Most investigator respondents were emergency medicine practitioners (13/21, 62%). Two-thirds of investigators were aware of the STARD 2015 guidelines (12/18, 67%) and overall agreed that incomplete reporting limits generalisability and the ability to detect risk of bias (median 4 (4, 5)). Investigators felt that the STARD 2015 guidelines were useful, easy to find and easy to use (median 4 (4, 4.25); median 4 (4, 4.25) and median 4 (3, 4), respectively). There was a shared opinion held by investigators and editors that the peer review process be primarily responsible for ensuring complete research reporting (median 4 (3, 4) and median 4 (3.75, 4), respectively). Three of 18 authors (17%) felt that the English publication language of STARD 2015 was a barrier to adherence.ConclusionsAlthough investigators and editors recognise the importance of completely reported research, reporting quality is still a core issue for POCUS research. The shared opinion held by investigators and editors that the peer review process be primarily responsible for reporting quality is potentially problematic; we view completely reported research as an integral part of the research process that investigators are responsible for, with the peer review process serving as another additional layer of quality control. Endorsement of reporting guidelines by journals, auditing reporting guideline adherence during the peer review process and translation of STARD 2015 guidelines into additional languages may improve reporting completeness for the acute POCUS literature.Trial registration numberOpen Science Framework Registry (https://osf.io/5pzxs/).

The abdomen

2019 ◽  
pp. 89-106
Author(s):  
Justin Bowra ◽  
Osama Loubani ◽  
Paul Atkinson
Keyword(s):  
Emergency Medicine ◽  
Bowel Obstruction ◽  
Peritoneal Fluid ◽  
Renal Colic ◽  
Point Of Care ◽  
Clinical Situation ◽  
Point Of Care Ultrasound ◽  
Quadrant Pain ◽  
Diagnosis And Management ◽  
Rule Out

Abdominal point-of-care ultrasound (PoCUS) for intra-peritoneal fluid in trauma is one of the earliest, and now most accepted, uses of PoCUS in emergency medicine and resuscitation. It is an essential part of the e-FAST (Extended Focused Assessment in Trauma) examination. Abdominal PoCUS can also guide diagnosis and management of right upper quadrant pain and renal colic. PoCUS can also ‘rule in’ (but not ‘rule out’) bowel obstruction and appendicitis. Regardless of the clinical situation, PoCUS is used to answer specific binary questions, rather than to perform an exhaustive survey of the abdomen.

20. POINT-OF-CARE ULTRASOUND EDUCATION FOR PEDIATRIC RESIDENTS: A MULTICENTER NEEDS ASSESSMENT

2020 ◽  
Vol 20 (7) ◽  
pp. e11-e12
Author(s):  
Austin S. Meggitt ◽  
David P. Way ◽  
Maya S. Iyer ◽  
John D. Mahan ◽  
Delia Gold
Keyword(s):  
Needs Assessment ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Education ◽  
Pediatric Residents
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