Ultrasound — Introductory and Advanced

Introductory Course - Saturday, September 5, 8:00am-3:00pm

Advanced Course - Sunday, September 6, 8:00am-12:00pm

Both Courses

Course Description

Ultrasound is a non-invasive bedside tool that serves as an extension of the physical exam. Patients do not need to leave the emergency department, so there is no prolongation of through-put time, no waiting for a diagnosis from a radiologist’s read, and it is well suited to use with unstable patients. In many countries, ultrasound has become the standard of care for both evaluation and procedural guidance. This year’s course is new, different and exciting; designed in response to evaluations from learners who attended previous MEMC sessions. 

Course Price:
Introductory Ultrasound
     Organizing Society Member (AAEM, GREAT, MAEM): €425*
     Members of Supporting Societies: €445*
     Non-Members: €465*
              *Box lunch included as part of the registration fee.

Advanced Ultrasound (note: lunch not provided)
     Organizing Society Member (AAEM, GREAT, MAEM): €280
     Members of Supporting Societies: €300
     Non-Members: €320

Introductory & Advanced Ultrasound
     Organizing Society Member (AAEM, GREAT, MAEM): €425*
     Members of Supporting Societies: €445*
     Non-Members: €465*
               *Box lunch included on Saturday as part of the registration fee.

Register for this Pre-Congress course!

Introductory Ultrasound Course Description

Participants wanted more imaging of the heart and central line placement. Didactic lectures will provide state of the art audiovisual presentation by a veteran faculty, followed by small groups of a maximum of five participants / one instructor allowing each individual participant ample time with their hand on the probe.

Introductory Ultrasound Course Learning Objectives

Echo and Aorta

  1. Identify the surface landmarks for appropriate transducer positioning to perform sonographic examinations of the thoracic and abdominal aorta.
  2. Demonstrate the ability to identify and visualize landmarks for the aorta in the transverse and longitudinal scanning planes.
  3. Analyze the sonographic findings and pitfalls for identifying pathology including aortic aneurysm.
  4. List the utility of motion modality (M-mode) and demonstrate its use.
  5. Demonstrate the surface landmarks and transducer position necessary to perform an echocardiogram in the ED.
  6. Acquire and interpret sonographic images of heart (subcostal, parasternal long, parasternal short, and apical windows).
  7. Identify pathologic conditions such as pericardial effusion, gross wall motion abnormalities, and cardiac tamponade.

eFAST

  1. Explore the surface landmarks for appropriate transducer positioning to perform the FAST examination.
  2. Classify the sonographic landmarks and anatomical relationships of the heart, liver, spleen, and bladder as they relate to the FAST examination.
  3. Demonstrate the ability to identify and visualize the areas of potential intra-abdominal and thoracic spaces for free fluid to collect or pneumothorax
  4. Describe the sonographic findings and pitfalls for identifying life-threatening trauma conditions such as cardiac tamponade, hemo/pneumothorax, and intra-abdominal hemorrhage.

Vascular Access

  1. Distinguish the sonographic landmarks and anatomical relationships as they relate to the vasculature of the neck, upper extremity, and groin.
  2. Acquire and interpret sonographic images of the internal jugular, femoral, basilic, brachial, and axillary veins in live patient models.
  3. Demonstrate ultrasound guided cannulation on vascular simulator.

Tentative Course Schedule — Introductory Ultrasound

Saturday, September 5, 2015 8:00am-3:00pm

8:00am- 8:15am
8:15am-9:00am
9:00am-9:45am
10:00am-10:15am
10:15am10:45am          
10:45am-11:30am
11:30am-12:30pm
12:30pm-2:45pm              
3:00pm  

 Welcome
Image Acquisition and Insturmentation
Trauma — eFast Examination 
Break  
Aorta   
Vascular Access — Central and Peripheral Lines
Lunch    
Modules      
Wrap-Up & Adjourn

Advanced Ultrasound Course Description

Participants enjoyed the Seventh Mediterranean Emergency Medicine Congress and we have added more modules. Didactic lectures will take place on-line at your convenience. The lectures will be available one month prior and one month following the advanced US course. There will be a maximum of five participants / one instructor allowing each individual participant ample time with their hand on the probe.

Advanced Ultrasound Learning Objectives
(Participants select 5 modules)

Echo and Aorta

  1. List the surface landmarks for appropriate transducer positioning to perform sonographic examinations of the thoracic and abdominal aorta.
  2. Demonstrate the ability to identify and visualize landmarks for the aorta in the transverse and longitudinal scanning planes.
  3. Analyze the sonographic findings and pitfalls for identifying pathology including aortic aneurysm.
  4. Explore the utility of motion modality (M-mode) and demonstrate its use.
  5. Demonstrate the surface landmarks and transducer position necessary to perform an echocardiogram in the ED.
  6. Acquire and interpret sonographic images of heart (subcostal, parasternal long, parasternal short, and apical windows).
  7. Identify pathologic conditions such as pericardial effusion, gross wall motion abnormalities and cardiac tamponade.

eFAST

  1. Identify the surface landmarks for appropriate transducer positioning to perform the FAST examination.
  2. Compare the sonographic landmarks and anatomical relationships of the heart, liver, spleen, and bladder as they relate to the FAST examination.
  3. Demonstrate the ability to identify and visualize the areas of potential intra-abdominal and thoracic spaces for free fluid to collect or pneumothorax
  4. Review the sonographic findings and pitfalls for identifying life-threatening trauma conditions such as cardiac tamponade, hemo/pneumothorax, and intra-abdominal hemorrhage.

EM Procedures

  1. List the sonographic landmarks and anatomical relationships as they relate to commonly performed procedures in the ED.
  2. Acquire and interpret sonographic images of the internal jugular, lung and chest wall, right upper abdominal quadrant, and heart.
  3. Demonstrate ultrasound guided thoracentesis, paracentesis, and pericardiocentesis on patient simulation models.

Gallbladder & Renal

  1. Explore the surface landmarks for appropriate transducer positioning to perform sonographic examinations of the aorta, kidney, and gallbladder.
  2. Compare the sonographic windows and landmarks of the aorta, kidney, and gallbladder.
  3. Demonstrate the ability to identify and visualize landmarks for the aorta, kidney, and gallbladder in the transverse and longitudinal scanning planes.
  4. Identify the sonographic findings and pitfalls for identifying pathology including aortic aneurysm, hydronephrosis, and cholelithiasis/cholecystitis.

Gastrointestinal

  1. Evaluate the sonographic appearance of normal stomach, large and small bowel, and pancreas, including normal anatomical structures and normal bowel peristalsis.
  2. Describe transducer choices, scanning protocols, and patient positions necessary to perform a gastrointestinal examination.
  3. Identify and detect gastrointestinal pathology such as ileus, pneumoperitoneum, appendicitis, colitis, diverticulitis, ileitis, intussusception, or hernias.
  4. Describe common sites of intra-and retroperitoneal free air, systematic examination techniques and pitfalls for appendicitis, pneumoperitoneum, colitis, diverticulitis, and hernia.

Head & Neck

  1. Define the normal sonographic appearance and anatomical landmarks of organs and structures in the head and neck region, including ocular, salivary glands, thyroid gland, the upper airway including larynx and trachea, upper esophagus, facial bones and neck vessels and lymph node anatomy.
  2. Describe transducer choices, scanning protocols and patient positions necessary to perform a focused ocular examination to detect retinal detachment, vitreous hemorrhage, lens dislocation, periocular free air, or increased intracranial pressure.
  3. Identify common thyroid abnormalities such as cysts or masses and the anatomical relation of the parathyroid glands.
  4. Describe the appearance of salivary glands and appearance of salivary stones. Identify lymph nodes within the neck.
  5. Describe ultrasound exam techniques to detect upper airway anatomy to guide correct ETT placement including normal esophagus and esophageal intubation.
  6. Analyze anatomy of main neck vessels and their relation to other musculoskeletal structures.

Image Acquisition and Instrumentation

  1. Enhance your basic understanding of the basic principles of ultrasound.
  2. Apply these principles to the reduction of common artifacts and improvement of high quality diagnostic ultrasound images.
  3. Explore the relationship between transducer position and image orientation.
  4. Demonstrate the basic operator controls on the ultrasound system required for image acquisition.

Landmark Documentation

  1. Demonstrate proper landmark documentation of a central line insertion.
  2. Demonstrate proper landmark documentation of the fast examination.
  3. Demonstrate proper landmark documentation of the heart (parasternal log, short, and subcostal views).
  4. Demonstrate proper landmark documentation of the gallbladder.

Musculoskeletal

  1. Discuss the advantages and disadvantages of diagnostic musculoskeletal ultrasound compared to other imaging modalities.
  2. Demonstrate the appearances of various tissues on diagnostic musculoskeletal ultrasound.
  3. Correctly apply ultrasound basic concepts so as to ensure proper visualization of musculoskeletal structures.
  4. Proficiently perform a diagnostic musculoskeletal ultrasound on various upper and lower limb structures.

Ocular

  1. Review and understand how sonography can reveal pathology of the eye and to highlight its usefulness as a simple and cost-effective tool in investigating eye symptoms.
  2. List the normal ultrasound anatomy of the eye, specifically the location of the retina.
  3. Determine which probe is needed for ultrasound scans of the eye and the method to accurately and safely perform the exam.
  4. Describe an example of a retinal detachment diagnosed by ultrasound.

Peripheral Nerve Blocks

  1. Discuss the science and practical performance of brachial plexus, axillary and femoral blockade.
  2. Examine the physiology and anatomy of the techniques and factors that influence success and complications.
  3. Demonstrate approaches for peripheral nerve blocks in the upper and lower extremity.
  4. Demonstrate peripheral nerve block on simulator under ultrasound guidance.

Practice with an Expert  

  1. Explore tips form an expert on live or simulated patient models that cover the core US modules of EM: fast, aorta, echo, gallbladder/renal, and vascular access.

Pulmonary

  1. Review and understand the sonographic artifacts of normal and pathologic pulmonary conditions that give pulmonary ultrasound its diagnostic capacity. This includes, but is not limited to, pleural imaging, the "lung sliding sign," B-line and comet tail identification for extravascular pulmonary congestion, and pleural effusion imaging techniques.
  2. Demonstrate sonographic landmarks of the ribs, pleura, diaphragm, and lung parenchyma.
  3. Distinguish between normal and pathologic condition through image review and hands-on imaging practice.

Shock

  1. Provide a sequenced approach to ultrasound in the medical shock patient.
  2. Demonstrate the surface landmarks and transducer position necessary to evaluate the heart, IVC, aorta, and peritoneum.
  3. Review causes and potential responses to treatments of hypotension and tissue malperfusion.

Shoulder

  1. Classify the indications for shoulder ultrasound — rotator cuff tears, subdeltoid/subacromial bursitis, etc.
  2. Assess the clinical presentation of these patients — dull chronic shoulder pain, difficulty sleeping, etc.
  3. List the technique for scanning the biceps tendon, subscapularis tendon, supraspinatus, and infraspinatus tendons.
  4. Identify the pitfalls of drop-out due to angulation, shadowing, fluid in the subdeltoid area, etc.

Ultrasound Equipment

  1. Outline how to be an expert on your ultrasound system.
  2. Explore how to safely connect and remove probes from their ports.
  3. Identify how to switch between transducers.
  4. Demonstrate how to store and review images.
  5. Demonstrate adjustments to controls i.e., gain, depth, and frequency in a hands-on session.
  6. Demonstrate how to properly document an ultrasound study by adding patient information, text annotation, and proper landmarks.

Vascular Access

  1. Explore the sonographic landmarks and anatomical relationships as they relate to the vasculature of the neck, upper extremity and groin.
  2. Acquire and interpret sonographic images of the internal jugular, femoral, basilic, brachial, and axillary veins in live patient models.
  3. Demonstrate ultrasound guided cannulation on vascular simulator.

DVT

  1. Classify the sonographic landmarks and anatomical relationships as they relate to the vasculature of the neck, upper extremity and lower extremity.
  2. Acquire and interpret sonographic images of the internal jugular, femoral, basilic, brachial, and axillary veins in live patient models.
  3. Demonstrate compression technique of upper and lower extremity veins.

Tentative Course Schedule — Advanced Ultrasound

Sunday, September 6, 2015

8:00am-8:45am
8:45am-9:30am
9:30am-10:15am
10:15am-10:30am
10:30am-11:15am
11:15am-12:00pm
12:00pm

 Module 1                               
Module 2
Module 3
Break
Module 4
Module 5
Adjourn

Advanced Modules: (Participants select 5 modules)

  1. Echo & Aorta
  2. eFast
  3. EM Procedures
  4. Gallbladder and Renal
  5. Gastrointestinal
  6. Head & Neck
  7. Image Acquisition and Instrumentation
  8. Landmark Documentation
  9. Musculoskeletal
  10. Ocular
  11. Peripheral Nerve Blocks
  12. Practice with an expert
  13. Pulmonary
  14. Shock
  15. Shoulder
  16. Ultrasound Equipment
  17. Vascular Access
  18. DVT

Course Directors

Michael J. Lambert, MD RDMS FAAEM
Fellowship Director Emergency Ultrasound, Dept. of Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, Illinois, USA

Joseph P. Wood, MD JD RDMS MAAEM FAAEM
Emergency Medicine Department, Mayo Clinic Hospital, Scottsdale, AZ

Faculty

Miteb Algithami, MD FRCPC
Beth Israel Deaconess Medical Center

Shari Brand, MD FAAEM
Department of Emergency Medicine, Mayo Clinic Hospital, Phoenix, Arizona

Eric Chin, MD FAAEM MAJ MC
Service Chief, Dept. of EM, Associate Program Director, Emergency Ultrasound Fellowship, Assistant Professor of Military and Emergency Medicine, USUHS SAUSHEC, San Antonio Military Medical Center, San Antonio, Texas, USA

John Christian Fox, MD FAAEM FAIUM
Professor and Vice Chair, Academic Affairs; Assistant Dean, Student Affairs, University of California, Irvine School of Medicine, San Clemente, California

Joseph Samuel Colla, MD

Rip Gangahar, MD
Consultant ED, The Royal Oldham Hospital; Trauma Lead, Pennine Acute Hospitals NHS Trust; Chair, IFEM US Group, Rochdale, United Kingdom

Courtney Gibson Anerin, MD
University of Alabama-Birmingham, Birmingham, Alabama, USA

John Gullett, MD

Beatrice Hoffmann, MD PhD FAAEM
Emergency Ultrasound Director, Beth Israel Deaconess Medical Center

Bob Jarman, FCEM
Visiting Professor (Point of Care Ultrasound), Teesside University & Consultant in Emergency Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, England

Ross Kessler, MD

John G. Knight, Jr., MD

Karen Lambert, MD FACC
Illinois Heart and Vascular, Hinsdale, IL

Jeffrey D. Morgan, MD
Department of Emergency Medicine, Brooke Army Medical Center, Fort. Sam Houston, Texas

Melissa Myers, CPT
Emergency Medicine PGY-3, Madigan Army Medical Center, Tacoma, Washington, USA

Bret P. Nelson, MD RDMS FACEP
Associate Professor, Director of Emergency Ultrasound, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY

Bhavesh Patel, MD FRCP(C) RDMS
Assistant Professor of Anesthesiology, Medicine and Neurology, Mayo Clinic College of Medicine, Education Director, Department of Critical Care Medicine, Mayo Clinic, Phoenix, Arizona

Gaurav Patel

Elena Skomorovsky, MD
Emergency Ultrasound Fellow, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts, USA

David Solomon, MD
Consultant Physician, Emergency, Medical Affairs, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates

 

Last updated: July 24, 2015