Ultrasound to Evaluate Fluid Responsiveness: A Curriculum for 4 th year Medical Students Paul Kukulski, MD, Michael Ward, MD, Keme Carter, MD University.

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Presentation transcript:

Ultrasound to Evaluate Fluid Responsiveness: A Curriculum for 4 th year Medical Students Paul Kukulski, MD, Michael Ward, MD, Keme Carter, MD University of Chicago BACKGROUND Sepsis is a leading cause of death in the ED We no longer strictly follow EGDT Ultrasound has been shown to help determine fluid responsiveness On day 1 of residency, interns need to be able to recognize and treat hypotension according to Entrustable Professional Activities 10, set forth by the AAMC

Ultrasound to Evaluate Fluid Responsiveness: A Curriculum for 4 th year Medical Students Paul Kukulski, MD, Michael Ward, MD, Keme Carter, MD University of Chicago METHODS 15 minute lecture; 45 minute practical 6 question pre- and post-test, validated by attendings, residents and incoming interns 6 question satisfaction survey

Ultrasound to Evaluate Fluid Responsiveness: A Curriculum for 4 th year Medical Students Paul Kukulski, MD, Michael Ward, MD, Keme Carter, MD University of Chicago RESULTS CONCLUSION ProCESS Investigators et al. “A Randomized Trial of Protocol-Based Care for Early Septic Shock”. New England Journal of Medicine May. 1;370(18): ProMISEe Trial Investigators et al. “Trial of Early, Goal-Directed Resuscitation for Septic Shock”. New England Journal of Medicine April. 2; 372(14): ARISE Investigators et al. “Goal-Directed Resuscitation for Patients with Early Septic Shock”. New England Journal of Medicine October. 16;371(16): Muller L, et al. “Respiratory Variations of Inferior Vena Cava Diameter to Predict Fluid Responsiveness in Spontaneously Breathing Patients with Acute Circulatory Failure: Need for a Cautious Use”. Critical Care October. 8; 16(5): R188 Lanspa MJ, eta al. “Applying Dynamic Parameters to Predict Hemodynamic Response to Volume Expansion in Spontaneously Breathing Patients with Septic Shock”. Shock February. 39(2): Flynn, Timothy et al. Core Entrustable Professional Activities for Entering Residency. AAMC Provided a significant increase in knowledge base Taught material not otherwise taught in medical school Was highly rated by medical students Addresses AAMC Entrustable Professional Activities 10 – ability to address hypotension on day one of residency REFERENCES p<0.01* *Represents statistically significant improvement in student scores