Award in Point of Care Ultrasound for Respiratory Medicine
Over 2 semesters, the program covers the Fundamentals of Ultrasound scanning and 3 essential clinical applications encountered in Respiratory Medicine including:
- Core ECHO and IVC
- Lung and Pleural Ultrasound
- Ultrasound-Guided Vascular Access and Procedural
Generic Information
• Limited to 5 candidates per course for effective mentorship
• Blend of online lectures/webinars and in-person practice
• Segmented online lectures aid self-paced learning
• Online portal for resources, mentor interaction, and submissions
• Each candidate is assigned an experienced mentor for year-long guidance
• Facilitation of access to practice machines
• 6-8 in-person intensive practice days per course
• Mandatory practice logbook with scans and pathologies
• Final exam with practical and theoretical elements for course completion.
Learning Outcomes
At the end of the course the candidate should be able to:
• Appreciate the fundamental physics principles relating to ultrasound including the piezoelectric effect, acoustic impedance mismatch, angle of incidence and other factors that influence imaging as well as the recognition and differentiation of various artefacts
• Recognise the importance of frequency and the way it impacts probe selection and imaging
• Utilise the various functions on US machines to optimise the scan and obtain measurements of relevant structures
• Hold and manipulate the probe effectively being mindful of ergonomics
• Identify the various artefacts. Be familiar with techniques to utillise friendly artefacts and eliminating or reducing unfriendly artefacts.
• Annotate and acquire representative images
• Be mindful of probe and machine cleaning and sterility
• Utilise key scanning concepts including perpendicularity, foreshortening, single component movement
• Use the correct terminology to describe findings and write a report
• Be aware of the role of Artificial Intelligence in POCUS
• Recognise the value of the various cardiac views in evaluating different cardiac structures
• Define the sonoanatomy and recognise the cardiac structures in all cardiac views
• Understand the changes in the cardiac chambers and valves during the cardiac cycle
• Define the normal upper limits for diameters and ratio of the cardiac structures
• Understand the clinical significance and relevance of dilated structures
• Define the normal ECHO parameters for LV contractility
• Acquire the parasternal long axis (PLAX) and short axis (PSAX) and subcostal views of the heart
• Utilise a stepwise approach to optimise the various cardiac views and recognise the impact of specific movements on the cardiac appearance
• Adopt the DEFG structured diagnostic approach for ECHO evaluation
• Correctly measure the aortic root, LA and LV in PLAX
• Identify a dilated aortic root LA and dilated cardiomyopathy
• Understand the clinical signficance of the findings
• Evaluate the systolic function/contractility to diagnose heart failure with reduced ejection fraction
• Identify pericardial effusions and recognise tamponade physiology
• Evidence base for IVC scanning
• Understand the impact of respiratory physiology on the IVC
• Identify and correctly measure the IVC
• Define the maximal diameter and collapsibility index of the IVC in normovolemia and hypovolemia in both ventilated and unventilated patients
• Appreciate the evidence base for lung and pleural ultrasound
• Understand the anatomy and sonoanatomy of the pleaura and lung
• Appreciate the surface landmarks delineating the 12 lung zones and the corresponding pulmonary anatomy
• Use a step wise structured approach for the evaluation of each lung zone
• Recognise the sonographic appearances of various pulmonary pathologies including pneumothorax, pleural effusion, pulmonary oedema, consolidation, fibrosis, contusion, pneumonitis and ARDS
• Evaluate the pleura for areas of thickening and differentiation from pleural effusion
• Integrate the findings with the clinical context to assist diagnosis
• Recognize the evidence base underpinning the use of US in central and peripheral venous access
• Understand the necessity of infection control measures and sterility
• Differentiate veins, arteries, nerves, muscles and tendons
• Evaluate the venous anatomy of the upper limb veins in a systematic way using ultrasound
• Assess peripheral vein suitability using the WASPS approach
• Identify and evaluate the radial and ulnar artery with a view to arterial cannulation
• Optimising probe to vessel alignment for access
• Utilise in-plane and out-of-plane approaches for guided vascular access and interventions
• Use ultrasound to confirm successful cannulation
• Apply the in plane and out of plane technique to procedures
• Map the chest wall, diaphragm and effusion location and depth prior to thoracocentesis
• Assist thoracocentesis with ultrasound using a static approach or real time guidance
• Use ultrasound to guide pleural aspiration
• Use ultrasound to assist pleural biopsy