Ultrasound – Advanced

Wednesday, 21 September 2022
13:00 – 17:00

Course Fee

• Organizing Society Member (AAEM, MAEM): $485
• Non-Member: $535

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

• Organizing Society Member (AAEM, MAEM): $775
• Non-Member: $815

Course Description

The advanced workshop will be module based. Participants will be able to select 5 modules and have hands-on time at each. Please note that the modules are subject to change, depending on the state of the pandemic and equipment availability.

Learning Objectives: At the conclusion of the course, each participant should be able to:
*learning objectives are unique for each module

*Participants will be able to select five (5) application modules:

1. 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.
2. 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.
3. 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.
4. 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.
5. Gallbladdder & 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.
6. 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.
7. 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.
8. Ocular
   1. Review and understand how sonography can reveal pathology of the eye and usefulness as a simple and cost-effective tool in investigating eye symptoms.
   2. Describe the normal ultrasound anatomy of the eye (cornea, lens, posterior chamber, retina and macula).
   3. Name 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, posterior vitreous hemorrhage, and lens dislocation diagnosed by ultrasound.
9. Patient Cases with Pathology
   1. Using ultrasound simulation trainer, 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.
10. 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.
11. 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.
12. 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.

Target Audience

Emergency Medicine practitioners with a basic knowledge and background in the use of point of care ultrasound (POCUS) that seek to improve their skills.

Course Prerequisite

There are no course prerequisites.

Course Agenda*

*agenda subject to change

Time	Topic	Faculty
13:00 - 13:45	Hands-on Module 1	Drs. Butts and Chin
13:45 - 14:30	Hands-on Module 2
14:30 - 15:15	Hands-on Module 3
15:15 - 15:30	Break
15:30 - 16:15	Hands-on Module 4
16:15 - 17:00	Hands-on Module 5
17:00 - 17:15	Wrap up & Adjourn	Drs. Butts and Chin

Course Directors

Christine Butts, MD FAAEM
Clinical Associate Professor, LSU Health Sciences Center, New Orleans, Louisiana, United States

Eric Chin, MD MBA FAAEM
Program Director, Emergency Medicine Residency, SAUSHEC Brooke Army Medical Center, San Antonio, TX, United States

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