Ultrasound Curriculum

Medical Student Rotation

140.32. EM Ultrasound at UCSF Fresno. (6 units)

The emergency ultrasound medical student elective is a four-week elective designed to introduce students to the use of point of care ultrasound in the emergency department.  Students will receive hands-on training as well as a variety of didactics to learn the basics of emergency ultrasound.  Students will be given required readings and lectures to help develop background knowledge of each of six main areas of emergency ultrasound including EFAST, aorta, biliary, cardiac, pelvic, and procedural.  Further, they will be given autonomy to practice and develop their ultrasound skills, scanning patients both with real time supervision and independently.  Images and videos will be saved electronically for later review at quality assurance meetings once per week.

Scheduling
The rotation is offered and scheduled on an individual basis beginning August of 2009.  

Senior Area of Concentration

A fourth year emergency medicine residency area of concentration in EM ultrasound is offered for interested residents.
Residents participating in the US AOC are expected to spend their designated time:

  1. doing ultrasound in the ED,
  2. teaching other residents EM ultrasound,
  3. doing focused readings regarding ultrasound,
  4. preparing teaching cases of interesting ultrasound studies, which may be added to the ultrasound website,
  5. participating in ultrasound research,
  6. meeting monthly for ultrasound-related discussions and reviews of their studies.

The standard EM ultrasound studies are:                                                                                  

  • FAST/eFAST
  • Biliary
  • Aorta
  • Cardiac
  • Renal
  • Pelvic—1st trimester pregnancy transvaginal and transabdominal
  • Procedural ultrasound, including central line placement, paracentesis. arthrocentesis, etc.

Each resident upon completing the AOC should have exceeded the minimum requirements of US for the residency program, which is 25 studies in each of the basic study categories as listed above.

Efforts will be made to discuss and learn how to do other types of studies, including DVT, nerve blocks, and introduction to testicular ultrasound focusing on the advanced use of doppler.

The ultrasound compendium produced through ACEP is a template for the AOC.

Attention will also be paid to the administrative issues of establishing an ultrasound program, quality improvement, privileging and credentialing, qualities of the ultrasound equipment including the machine and probes, and coding and billing issues.

At the completion of the AOC, the resident should be confident in their EM ultrasound skills and be able to become a lead person in ultrasound for the development and/or advancement of EM ultrasound where they practice emergency medicine

Resident Certification

All residents are required to complete ultrasound certification prior to graduation.  The ACEP recommendations have been used as a guideline to create an ultrasound curriculum which includes:

  • 8 hours of didactics per year
    • Must attend 4 hours of live lecture
    • 4 hours may be online
  • 185 Studies submitted online (www.ehealthconx.com) for review
    • 25 Cardiac
    • 25 Renal/GU
    • 25 Aorta
    • 25 Pelvic Transvaginal
    • 25 Pelvic Transabdominal
    • 25 Biliary
    • 25 FAST
    • 10 Procedural (central line, abscess, etc)
  • 2 Case Studies
    • Paragraph with images/video
    • To be placed on the website for continued education
  • At the conclusion resident receive:
    • Certificate
    • Letter if required by their employer

Monthly ultrasound clinics devoted to hands-on teaching of bedside ultrasound techniques are given by Dr. Chooljian and Dr. Bengiamin.  This provides an opportunity for uninterrupted instruction and feedback.

Teaching Cases

This website includes ultrasound teaching cases from the UCSF Fresno Emergency Medicine Residency. Click onto the various versions of the video to assess your ability to interpret the scans. The version marked Full consists of video that is narrated and marked. The history and clinical courses of the real cases are included where available.