Medical Student Ultrasound Rotation

St. Luke’s Anderson Medical Student Point of Care Ultrasound Elective

What is Point of Care Ultrasound (POCUS)?

Point of Care Ultrasound (POCUS) is the medical use of ultrasound (US) technology for the bedside evaluation of acute or critical medical conditions. It is utilized for diagnosis of any emergency condition, resuscitation of the acutely ill, critically ill or injured, guidance of procedures, monitoring of certain pathologic states and as an adjunct to therapy. POCUS examinations are typically performed, interpreted, and integrated into care by the treating physician.  It may be performed as a single examination, repeated due to clinical need or deterioration, or used for monitoring of physiologic or pathologic changes. POCUS is a separate entity distinct from the physical examination that adds anatomic, functional, and physiologic information to the care of the acutely-ill patient. It provides clinically significant data not obtainable by inspection, palpation, auscultation, or other components of the physical examination.

- based on the ACEP Policy Statement: Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine June 2016

OBJECTIVES

• Understand basics of obtaining and recording standardized exam-specific views and calculations
• Understand basic ultrasound physics and concepts such as gain, depth & artifact; be able to utilize these concepts to improve image quality
• Gain proficiency in performing and interpreting the most frequently used applications: EFAST, Focused echo, thoracic, DVT, Aorta, RUSH, soft tissue, biliary, renal, basic musculoskeletal, ocular and 1^st trimester pregnancy
• Gain proficiency in basic procedural applications of ultrasound: peripheral IV access, central venous access, paracentesis/thoracentesis, arthrocentesis

REQUIREMENTS

Participation:

• Perform a minimum of FOUR scanning shifts per week of rotation averaged over the total rotation time.Each scanning shift will take place in the St. Luke’s Anderson Emergency Department and should be at least four hours long.You will have flexibility when scheduling scanning shifts, however it is expected that you scan when Ultrasound Faculty is working clinically.
• Attend mandatory Quality Assurance video review (QA) sessions. These are held once a week, usually on Friday mornings. You will receive a confirmatory email or text message prior to QA day, schedule is usually discussed at the beginning of the week to ensure everyone can attend.These sessions are important opportunities to discuss pathology, evidence-based practices and to get feedback on scans done during the week.
• Perform and record a minimum of 50 scans during your rotation. Each scan must be archived for review/QA purposes.Scans done in any Simulation or Educational session may be logged as well and can contribute to your overall number of scans.
• Scans done in the emergency department for clinical (non-educational) purposes should be reviewed in real time by an attending to ensure proper technique and interpretation.
• Scans should be as complete as possible and labeled appropriately.
• You will also be responsible for keeping our ultrasound machine clean and functioning and to help keep us stocked in ultrasound supplies. Prior to the start of your scanning shift:
  • Wipe touchpad/keyboard with wipes (avoid wiping screen, if screen is dirty use minimally damp paper towel)
  • Wipe probe and probe cords with wipes
  • Ensure no tape or patient labels are stuck to machine
  • Make sure cart is stocked with the following things:
    • Extra Ultrasound Gel
    • Sterile Probe Covers x 3
    • Tegaderms
    • Long 18g US needles
  • If you notice supplies are low, please let the charge nurse know.
  • If you notice issues with the machine let Dr. Gharib know immediately via text.

SITES:  St. Luke’s Anderson Emergency Department

ROTATION DIRECTOR:  Dr. Amr Gharib (Amr.Gharib@sluhn.org)

REFERENCE TEXTBOOKS:

• Manual of Emergency and Critical Care Ultrasound by Bret Nelson and Vicki Noble (PDF posted on TEAMS)
• Introduction to Bedside Ultrasound Volume 1 and 2 by Dawson and Mallin on iBooks (Free)
  • ‎Introduction to Bedside Ultrasound: Volume 1 on Apple Books
  • Introduction to Bedside Ultrasound: Volume 2 on Apple Books
• Additional reference videos: https://vimeo.com/aeus