Delivering training in ICM ultrasound - the UK way

Background

The use of point-of-care US on the ICU is expanding

Numerous courses but lackFormal accreditationIntegration into national

training programme

DEVELOP A COMPREHENSIVE COMPETENCY-BASED TRAINING PROGRAMME IN POINT-OF-CARE ULTRASOUND ON THE ICU

Core Ultrasound Skills in Intensive Care (CUSIC)

PHASE 1: Initial theoretical and practical trainingE-learningCourse

PHASE 2: Supervised practice until competence demonstrated in acquiring and saving images

PHASE 3: Mentored practice with completion of log book demonstrating knowledge of an appropriate range of pathology 

PHASE 4: Completion of competency assessments within the range of practice

http://www.e-lfh.org.uk/programmes/icu-echoultrasound/sample-session/

ECHOCARDIOGRAPHY Focused Intensive Care Echocardiography (British Society of Echocardiography) 10 scans under direct supervision Logbook with 50 (suitable) cases Triggered assessment

LUNG BLU protocol 50 scans (no more than 10 normal) Ultrasound-guided pleural

aspiration and drainage Triggered assessment

ABDOMINAL Recognition of US

appearance ofbowelliverspleenKidneys

(eFAST and AAA) Assessment and drainage

of ascites

VASCULAR Real-time Short and long axis No minimum number CVC Sites

Internal Jugular Femoral (Subclavian)

Discussion Clearly defined goals, competencies and timeframe

Standardisation of training & reporting tools Governance Quality Control Projects and Research Collaborations

Limitations/Challenges Inaugural year Resources and sustainability – time, expertise

Further information/reading Expert Round Table on Ultrasound in ICU, Cholley B et al (2011)

International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37:1077–1083

Intensive Care Society UK CUSIC Accreditation - http://www.ics.ac.uk/ics-homepage/accreditation-modules/cusic-accreditation/

Online resources #POCUS - twitter

Oxford Point-of Care Ultrasound Programme avkwong@mac.com, graham_n_barker@hotmail.com @avkwong