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American Academy of Emergency Medicine

Ultrasound - Advanced

        

                 

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Ultrasound - Advanced

Thursday, February 18, 2016
8:00am-12:00pm

Course Description
Course Fee
Credit Designation Statement

Learning Objectives
Course Schedule
Course Director
Faculty

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Course Description  

Participants loved last year’s course and we have added more modules. Didactic lectures will take place online at your convenience. The lectures will be available one month prior and one month following the advanced US course. There will be a maximum four participants / one instructor allowing each individual participant ample time with their hand on the probe.


Course Fee

On or before January 25, 2016

  • Advanced Ultrasound - only
    • $300 AAEM member
    • $450 Non-member
       
  • Advanced AND Beginner Ultrasound
    • $425 AAEM member
    • $575 Non-member

January 26, 2016 and after

  • Advanced Ultrasound - only
    • $400 AAEM member
    • $550 Non-member
       
  • Advanced AND Beginner Ultrasound
    • $525 AAEM member
    • $675 Non-member

Credit Designation Statement

The American Academy of Emergency Medicine (AAEM) designates this live activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Learning Objectives

DVT    

  1. Understand 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.

Echo and Aorta

  1. Understand 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. Understand the sonographic findings and pitfalls for identifying pathology including aortic aneurysm.
  4. Understand 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. Understand the surface landmarks for appropriate transducer positioning to perform the FAST examination.
  2. Understand 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. Understand the sonographic findings and pitfalls for identifying life-threatening trauma conditions such as cardiac tamponade, hemo/pneumothorax and intra-abdominal hemorrhage.

EM Procedures - Non-vascular

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

Gallbladder & Renal     

  1. Understand the surface landmarks for appropriate transducer positioning to perform sonographic examinations of the aorta, kidney and gallbladder. 
  2. Understand 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. Understand the sonographic findings and pitfalls for identifying pathology including aortic aneurysm, hydronephrosis and cholelithiasis/cholecystitis.

Gastrointestinal

  1. Understand 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. Understand 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. Understand 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 lymphnodes within the neck. 
  5. Describe ultrasound exam techniques to detect upper airway anatomy to guide correct endotracheal tube placement including normal esophagus and appearance of esophageal intubation.  
  6. Understand 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. Understand 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.
  5. Discuss the advantages and disadvantages of diagnostic musculoskeletal ultrasound compared to other imaging modalities. 
  6. Demonstrate the appearances of various tissues on diagnostic musculoskeletal ultrasound. 
  7. Correctly apply ultrasound basic concepts so as to ensure proper visualization of musculoskeletal structures. 
  8. Proficiently perform a diagnostic musculoskeletal ultrasound on various upper and lower limb structures.

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. To 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. Understand the normal ultrasound anatomy of the eye, specifically the location of the retina.
  3. Know which probe is needed for ultrasound scans of the eye and the method to accurately and safely perform the exam. 
  4. Visualize an example of a retinal detachment diagnosed by ultrasound.

Pelvic Ultrasound         

  1. Understand the indications for emergency screening ultrasound examinations of the pelvis. 
  2. Describe the surface landmarks and transducer position necessary to perform endovaginal ultrasound examinations of the pelvis.
  3. Perform an endovaginal US on model patients demonstrating correct scanning technique. 
  4. Interpret common diagnoses in first trimester pregnancy.

Peripheral Nerve Blocks

  1. Discuss the science and practical performance of brachial plexus, axillary and femoral blockade. 
  2. Learn 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.

Pitfalls and Errors         

  1. Understand common errors in EM US practice.
  2. Learn how to avoid these errors in your practice.

Practice with an Expert  

  1. Learn tips form an expert on live or simulated patient models that cover the core US modules of EM: fast, aorta, echo, gallbladder/renal, 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. Review 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. Understand the indications for shoulder ultrasound - rotator cuff tears, subdeltoid / subacromial bursitis, etc.
  2. Understand the clinical presentation of these patients - dull chronic shoulder pain, difficulty sleeping, etc.
  3. Learn the technique for scanning the biceps tendon, subscapularis tendon, supraspinatus and infraspinatus tendons. 
  4. Understand the pitfalls of drop-out due to angulation, shadowing, and fluid in the subdeltoid area, etc.

Testicular

  1. Learn and demonstrate the landmarks for the testes in the longitudinal and transverse plane.
  2. State the importance of using color Doppler and pulsed wave Doppler to indicate the waveform of vessels in the testes and epididymis.
  3. Review the following disorders of the testes: hydrocele, varicocele, orchitis, epididymitis and varicocele.

Ultrasound Equipment 

  1. Learn to be an expert on your ultrasound equipment.
  2. Learn how to safely connect and remove probes from their ports.
  3. Learn how to switch between transducers. 
  4. Learn and demonstrate how to store and review images. 
  5. Demonstrate adjustments to controls ie; gain, depth, frequency in hands-on session. 
  6. Demonstrate how to properly document an ultrasound study by adding pt. information, text annotation and proper landmarks. 

Vascular Access

  1. Understand 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. 

 


Course Schedule

Thursday, February 18, 2016
8:00am-1:00pm

Participants select five advanced application modules: 

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


Course Director

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

 

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