Toward an ultrasound curriculum for critical care medicine

Abstract

Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high level of quality is necessary, guaranteed by appropriate education, experience, credentialing, quality control, continuing education, and professional development. Although educational recommendations have been proposed by a variety of nonimaging specialties, to date they are still scattered and limited examples of standards for critical and intensive care professionals. The challenge of providing adequate specialty-specific training, as encouraged by major medical societies, is made even more difficult by the diversity of critical care ultrasound utilization by various subspecialties in a variety of settings and numerous countries. In order to meet this educational challenge, a standard core curriculum is presented in this manuscript. The proposed curriculum is built on a competence, performance, and outcomes-based approach that is tailored to setting-specific training needs and prioritized according to critical problem-based pathways, rather than traditional organ-based systems. A multiple goal-oriented style fully addresses the specialty-specific approach of critical and intensive care professionals, who typically deal with disease states in complex scenarios rather than individual organ complaints. Because of the variation in the concept of what constitutes critical care worldwide, and the rate of change of information and technology, this manuscript attempts to present a learning system addressing a variety of needs for a rapidly changing world.

Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management

“…Curriculum and didactics are being implemented in emergency medicine, medical schools, and critical care programs throughout the United States and internationally with a high degree of accuracy and retention [1,9,10,[20][21][22]. Many programs are also being offered for postgraduate studies and for clinicians in the field.…”

“…Fig. 4 Upward trend in performance score for the Nicaragua medical personnel using point of care ultrasound A previous lack of international standardized ultrasound training prompted Neri et al to propose an international ultrasound curriculum for critical care [20]. A modified international ultrasound curriculum was the basis for the ultrasound training to the Nicaraguan clinicians (Table 1).…”

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

“…However, the concept of FAST has undergone a significant evolution and the acronym now stands for ''Focused Assessment with Sonography for Trauma'' [4], as an increasing number of other aspects of trauma are being included. Ultrasound (US) assessment is now integrated in the ABCDE triage [5] and in the concept of resuscitative ultrasound (RUS), a ''holistic'' approach which includes evaluation of almost all aspects of multiple trauma patients in whom US is increasingly being used as an important bedside tool to enhance the sensitivity of clinical examination [6].…”

Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department

“…Bedside US is a safe technique, available even in poor environments, precise in a wide range of pathologic scenarios, legally performable by all physicians within their own specializations, and enforceable with clear objective in various clinical settings, being considered as ''the stethoscope of the 21st century'' [6][7][8]. Bedside US is now inserted among the compulsory professionalizing activities of different Specialization Schools, such as Internal Medicine and Emergency Medicine.…”