27th Annual Scientific Assembly

Ultrasound — Advanced

Thursday, June 24, 2021
8:00am-12:30pm
Regency C

Note: This course is only offered to in-person attendees.

Course Description

This year’s AAEM post-conference ultrasound course has been fully updated to reflect participants’ wishes in designing the ultimate ultrasound course. Participants loved AAEM’s 2019 Advanced course and we have added more modules this year including transesophageal echo (TEE) training and case-based simulation scenarios. 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 to one instructor allowing each individual participant ample hands-on time for ultrasound scanning.

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**New**Optional “FAST Exam Skills Verification

Wednesday, June 23, 2021
5:15pm-6:15pm

The Skills Verification Program (SVP) provides an opportunity for physicians to obtain a number of proctored FAST exams with a signed record. Physicians will be able to use this record as part of the privileging/credentialing process for performing and billing for FAST exams at their individual institutions. This program is open to the first 20 participants of either the Beginner or Advanced courses.

Note: The FAST Exam Skills Verification will only be offered to in-person attendees.

 

CME

Accreditation Statement
The American Academy of Emergency Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Course Credit Designation Statement
The American Academy of Emergency Medicine (AAEM) designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

Course Fee

  • AAEM Member: Early Bird $375 | Late: (after May 28) $475
  • Non-AAEM Member: Early Bird: $525 | Late: (after May 28) $625
  • AAEM/RSA Resident Member: Early Bird: $375 | Late: (after May 28) $535
  • Resident Non-Member: Early Bird: $435 | Late: (after May 28) $535

Course Fee — Special Discount if taking both Ultrasound — Beginner and Advanced

  • AAEM Member: Early Bird $600 | Late: (after May 28) $700
  • Non-AAEM Member: Early Bird: $750 | Late: (after May 28) $850

FAST Exam Skills Verification

$75 (Limited to first 20 participants / pre-registration required.)

Includes membership to the Emergency Ultrasound Section of AAEM (EUS-AAEM) pending eligibility (must be an AAEM or AAEM/RSA member).

Course Registration Limit: 36 participants

 

Tentative Course Schedule

Thursday, June 24, 2021

8:00am-8:15am

Welcome
Katharine Burns, MD FAAEM

8:15am-9:00am

Hands-on Module 1

9:00am-9:45am

Hands-on Module 2

9:45am-10:30am

Hands-on Module 3

10:30am-10:45am

Coffee Break

10:45am-11:30am

Hands-on Module 4  

11:30am-12:15pm

Hands-on Module 5

12:15pm-12:30pm

Wrap-up & Adjourn
Katharine Burns, MD FAAEM

 

Pick 5 Application Modules

  1. Aorta & Inferior Vena Cava
  2. Cardiac-Advanced
  3. DVT
  4. eFast
  5. Gallbladder & Renal
  6. Image Acquisition & Landmark Documentation
  7. Musculoskeletal-General
  8. Musculoskeletal-Shoulder
  9. Patient Cases with Pathology
  10. Procedures-Peripheral Nerve Blocks
  11. Procedures-Vascular Access
  12. Pulmonary
  13. Shock
  14. Transesophageal Echocardiography (TEE)

 

Learning Objectives

Aorta & Inferior Vena Cava           

  1. Identify the surface landmarks for appropriate transducer positioning to perform sonographic examinations of the abdominal aorta and inferior vena cava (IVC).
  2. Distinguish visual landmarks for the aorta and IVC in the transverse and longitudinal scanning planes.
  3. Describe the sonographic findings and pitfalls for identifying pathology including aortic aneurysm.
  4. Recognize the utility of motion modality (M-mode) and demonstrate its use.
  5. Acquire and interpret sonographic images of heart (subcostal) and IVC in the transverse and longitudinal planes.
  6. Categorize volume status of the IVC based on size and responsiveness to fluid.

Cardiac-Advanced

  1. Recognize the utility of motion modality (M-mode) and demonstrate its use.
  2. Demonstrate the surface landmarks and transducer position necessary to perform an echocardiogram.
  3. Acquire and interpret sonographic images of heart (subcostal, parasternal long, parasternal short and apical windows).
  4. Identify pathologic conditions such as pericardial effusion, gross wall motion abnormalities and cardiac tamponade.
  5. Show landmarks and measurements for cardiac output.
  6. Describe US findings for diastolic and systolic heart failure.

DVT

  1. Describe 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.

eFast

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

Gallbladder & Renal        

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

Image Acquisition and Landmark Documentation

  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. Describe the relationship between transducer position and image orientation.
  4. Demonstrate the basic operator controls on the ultrasound system required for image acquisition.
  5. Demonstrate proper landmark documentation of core ultrasound applications.

Musculoskeletal-General

  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.

Musculoskeletal-Shoulder

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

Patient Cases with Pathology      

  1. Using live models paired with simulation equipment, perform ultrasound exams to reveal abnormal pathology and discover the patient diagnosis.
  2. Demonstrate the ability to recognize critical pathology seen on ultrasound within a case-based scenario.

Procedures-Peripheral Nerve Blocks

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

Procedures-Vascular      

  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.

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.

Transesophageal Echocardiography (TEE)

  1. Demonstrate the TEE probes four possible movements. Insertion, Rotation (clockwise or counterclockwise), Flexion (Anteflexion / Retroflexion), Multiplane Beam Angle (0 - 180 degrees).
  2. Demonstrate the midesophageal 4-chamber view similar to the apical 4 chamber view in TTE. Where visualization of both the left and right ventricles and atria as well as the tricuspid and mitral valves in the same plane.
  3. Demonstrate the midesophageal long-axis view similar to the parasternal long-axis view in TTE. Where visualization of the mitral and aortic valves in the same plane along with the left atrium, left ventricle, and the outflow tract of the right ventricle.
  4. Demonstrate the transgastric short axis view similar to the parasternal short- axis in TTE, with the difference being the location of the inferior wall closest to probe in TEE rather than the anterior wall being closest to the probe as in TTE.

 

Course Co-Directors

Katharine Burns, MD FAAEM
Ultrasound Fellowship Co-Director, Advocate Christ Medical Center, Oak Lawn, IL; Clinical Assistant Professor, University of Illinois-Chicago College of Medicine, Chicago, IL

Eric J. Chin, MD MBA FAAEM
Program Director, SAUSHEC/BAMC Emergency Medicine Residency, San Antonio, TX

 

Course Faculty

Joshua Guttman, MD FAAEM
Emergency Ultrasound Fellowship Director, Emory University, Atlanta, GA

Beatrice Hoffmann, MD PhD FAAEM
Associate Professor, Beth Israel Deaconess Medical Center Group, Boston, MA

Patrick G. Kishi, MD
Fellow-in-training, Dept. of Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, IL

Wayne A. Martini, MD
Associate Ultrasound Director, Abrazo Health, Phoenix, AZ

Melissa Myers, MD FAAEM
San Antonio Military Medical Center, San Antonio, TX