1. Critical care ultrasound - Implementing international guidelines into clinical practice.
B. Arnason, N. Jonsson, P. Sigurjonsson, P. Rudberg, J. Nordström, J. Elzén, M. Ericsson, E. Larsson, L. Bergenzaun
Educational program in critical care ultrasound
The purpose of this study was to create and plan to implement an educational program in Critical Care Ultrasound (CCUS) and basic level of Critical Care Echocardiography (CCE), in the Department of Anesthesia and Intensive Care at Karolinska University Hospital.
The curriculum is in accordance with international recommendations of structured ultrasound curriculum models.
Background: Meticulous assessment and critical decision- making are essential to decrease morbidity and mortality and to improve performance in intensive care medicine. In recent years, Point of Care Ultrasound (PoCUS) has become an invaluable tool in the clinical evaluation of the critically ill.
Recent international guidelines, stress that intensive care physicians, should be competent in CCUS and CCE.
An implementation of CCUS in clinical practice requires appropriate education, credentialing, quality control, continuing education and clinical governance.
Results:
The curriculum was adopted from international guidelines. It consists of an introduction course with 10h of didactics and 8h of hands-on sessions on healthy volunteers.
The course covers basic ultrasound physics, knobology and image acquisition and interpretation. The curriculum includes basic critical care echocardiography, lung ultrasound, hemodynamic assessment and abdominal ultrasound including aorta and eFAST.
Furthermore, participants receive continuous teaching in combination with lectures, bedside demonstrations and case presentations supervised by an experienced intensivist.
Finally 30 adequately performed CCE and 20 CCUS in critically ill patients must be assessed and discussed in their clinical context with a faculty supervisor before approval.
The program is voluntary and available to both residents in training and specialists in anesthesia and intensive care.
Methods
A systematic literature review and needs analysis was conducted to define the basis of the ultrasound educational program.
An already existing two-day course in point of care ultrasound at our department was extended and adjusted to fulfill the requirements of CCUS and basic level of CCE.
An e-based logbook was created, facilitating the documentation of sonographic examinations.
All faculty supervisors are intensive care physicians with extensive experience in focused sonographic examinations
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Karolinska Sjukhuset
Bjarni Arnason MD
Dpt. of Anesthesia and Intensive Care
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