Ultrasound in the emergency department

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ME 2.6.1.1

Physics of ultrasound waves and artefacts production

ME 2.6.1.2

Ultrasound machine controls and image optimisation

ME 2.6.1.3

Bio-effects, safety, infection control and machine maintenance

ME 2.6.1.4

Normal anatomy as viewed in ultrasound images, as pertains to FELS, EFAST, AAA, and lung ultrasound. Demonstrate knowledge and understanding of:

ME 2.6.2.1

Obvious pathologies as viewed in ultrasound images.

ME 2.6.2.2(a)

The role of common bedside ultrasound skills used in resuscitation assessment, including: Focused Echocardiography in Life Support (FELS)

ME 2.6.2.2(b)

The role of common bedside ultrasound skills used in resuscitation assessment, including: Extended Focused Assessment with Sonography for Trauma (EFAST)

ME 2.6.2.2(c)

The role of common bedside ultrasound skills used in resuscitation assessment, including: Abdominal Aortic Aneurysm (AAA) assessment

ME 2.6.2.3

The role of ultrasound guided procedures when resuscitating adults, including peripheral and central venous access.

ME 2.6.2.4

Perform ultrasound-guided insertion of peripheral IV cannula.

ME 2.6.3.1

The role of bedside ultrasound used in the resuscitation assessment of lungs in adult patients.

ME 2.6.3.2

Advantages and disadvantages of procedural ultrasound guidance of a needle when compared to performance based on anatomical landmarks, including common nerve blocks and central venous access.

ME 2.6.3.3

The role of bedside ultrasound in paediatric emergency resuscitation.

ME 2.6.3.4

Findings and limitations of limited and comprehensive ultrasound assessment in emergency medicine.

ME 2.6.3.5(a)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: First trimester ultrasound for the presence or absence of intrauterine pregnancy

ME 2.6.3.5(b)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Formal pregnancy/gynaecological pelvic ultrasounds

ME 2.6.3.5(c)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Hepatobiliary ultrasound

ME 2.6.3.5(d)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Renal ultrasound

ME 2.6.3.5(e)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Doppler for vascular applications

ME 2.6.3.5(f)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Ultrasound for ruptured tendons and joints

ME 2.6.3.5(g)

Incorporate bedside ultrasound assessment results in diagnostic reasoning, including: Soft tissue ultrasound

ME 2.6.3.6

Perform Focused Echocardiography in Life Support (FELS) for the detection of cardiac activity during cardiac arrest

ME 2.6.3.7(a)

Perform the following ultrasound-guided procedures: Central IV cannula insertion

ME 2.6.3.7(b)

Perform the following ultrasound-guided procedures: Femoral nerve and fascia iliaca blocks

ME 2.6.4.1(a)

Advanced applications of bedside ultrasound beyond the resuscitation setting, including: Needle-guided procedures beyond vascular access

ME 2.6.4.1(b)

Advanced applications of bedside ultrasound beyond the resuscitation setting, including: Combining lung, FELS, AAA and EFAST scanning into haemodynamic assessment protocols, e.g., RUSH

ME 2.6.4.1(c)

Advanced applications of bedside ultrasound beyond the resuscitation setting, including: Other disease presentations, e.g., assessment of free peritoneal fluid to suspected ectopic or assessment of ascites, vascular presentations, other abdominal presentations, soft tissue pathology, obstetric and gynaecological presentations.

ME 2.6.4.2(a)

Perform the following ultrasound-guided procedures, in-plane or out- of-plane: Pleural drains

ME 2.6.4.2(b)

Perform the following ultrasound-guided procedures, in-plane or out- of-plane: Ascitic drains

ME 2.6.4.2(c)

Perform the following ultrasound-guided procedures, in-plane or out- of-plane: Joint aspirations

ME 2.6.4.3(a)

Perform the following ultrasound assessments: FELS (effusion, cardiac activity, LV systolic function, RV strain, gross volume assessment)

ME 2.6.4.3(b)

Perform the following ultrasound assessments: AAA (detection of aneurysm)

ME 2.6.4.3(c)

Perform the following ultrasound assessments: EFAST (pneumothorax, fluid in pericardium, thorax or peritoneum, distended bladder)

ME 2.6.4.3(d)

Perform the following ultrasound assessments: Lung (lung sliding, interstitial syndrome, consolidation, effusions, pneumothorax, pulmonary oedema)

ME 2.6.4.4

Adjust clinical decisions based on image quality and diagnostic performance of ultrasound.