Visit
Apply
Give

College of Medicine MD Curriculum

Emergency Ultrasound – UTMC (2 week)

Title of Clerkship: Emergency Ultrasound – UTMC (2 week)

Elective Year(s): Fourth-Year Elective

Department: Emergency Medicine

Type of Elective: Clinical

Clerkship Site: The University of Toledo Medical Center & ProMedica Toledo Hospital

Course Number: ERMD 716

Blocks Available: All

Number of Students/Block: 1-2

Faculty: Dr. Mohamad Moussa  and various Emergency Medicine Faculty

Elective Description/Requirements: The utilization of bedside (point-of-care) emergency ultrasound is expanding, becoming a key to providing efficient and effective patient care.  This elective introduces a 4th year medical student with emergency medicine, sports medicine, and/or primary care interest to the basics of performing and interpreting bedside ultrasound in the emergency department.  They will receive one-on-one bedside teaching in the use of emergency ultrasound with attending physicians and residents and the ability to scan on their own with appropriate supervision. In addition to hands-on learning in the emergency department, training will also consist of SIM center training sessions, echocardiography shadowing, and online training modules.

Length of Clerkship: 2 weeks

Links to Core Competencies/Educational Course Objectives: At the end of this elective, the student will be able to:

  1. Describe where point-of-care ultrasound fits into emergency medicine, sports medicine, and primary care settings. (EPOs: PC-9, SBP-1)
  2. Describe the basic physics and knobology of ultrasound, highlighting prob strengths and weaknesses. (EPOs: MK-4, PC-6)
  3. Demonstrate proper setup, cleaning, utilization, and storage of a typical ultrasound machine. (EPOs: MK-1)
  4. Perform ultrasound studies in the core areas of emergency ultrasound. (EPOs: PC-6, PC-7, PC-9)
  5. Electronically store ultrasound images and retrieve images as necessary. (EPOs: PC-6)
  6. Communicate ultrasound findings to the physician(s) and resident(s) taking care of the patient that was imaged. (EPOs: PC-2, PC-9)
  7. Describe how ultrasound can prevent unnecessary CT scan imaging. (EPOs: SBP-1, SBP-3)
  8. Enumerate the limitations of bedside ultrasound. (EPOs: PC-7)
  9. Compare and correlate the bedside ultrasound performed by the student to formal studies ordered by the physician(s). (EPOs: PBL-1, IPC-2)
  10. Demonstrate the ability to self-teach and perform bedside ultrasound using online references and applications. (EPOs: PBL-2, PC-6)

Professionalism: UT/COM students will meet or exceed the institutional standards for professionalism as stated in the current Educational Program Objectives and the current Educational Course Objectives for the Sponsoring Department.

Requirements: Eight 6-hour scan shifts (Mon-Fri) over 2-week elective rotation with faculty & residents, including one shadow shift in the cardiology suite.  Total number of scans can vary based on time of year and ultrasound director’s discretion.

Instructional Methods:

  1. Individual and supervised bedside ultrasound scanning.
  2. Simulation Center training
  3. Independent Study
  4. Online modules with additional references and applications
  5. Brief presentation of 1 ultrasound case at weekly didactics or other presentation at ultrasound director’s discretion.

Evaluation Methods:

  1. Pretest 1 & Post-test http://emergencyultrasoundteaching.com/
  2. Debrief session with Ultrasound Director at the end of the elective.
  3. Procedure competency evaluations completed by faculty & residents using standardized direct observation tool (SDOT) forms.

Resources:

  1. Ultrasound Lab in Simulation Center UTMC Campus Rm. 2211
  2. Smartphone app: EM Ultrasound by Peter Canning, MD, EM Apps, LLC ($5 optional)
  3. http://emergencyultrasoundteaching.com/
  4. Reference: Introduction to Bedside Ultrasound (iBook) (download)
  5. Select journal articles (US for Chest Pain & Abd Pain)
  6. AAFP organ-specific slides

Prerequisites: At least one emergency medicine clinical rotation (any site)

Clerkship Director: Allen Williams, M.D.

Ultrasound Director: Mohamad Moussa, M.D., R.D.M.S. 

Clerkship Coordinator: Amy Blevins
Phone Number: 419-383-6318
Email: Amy.Blevins@utoledo.edu

Special Requirements: None

Ultrasound scans to be covered

  1. Measurement of optic nerve sheath diameter for intracranial pressure
  2. Retinal detachment detection
  3. Pneumothorax detection- lung sliding, comet tails
  4. B-Lines for pulmonary edema
  5. Cardiac/Echo – estimating contractility, detecting pericardial effusion, right ventricular size
  6. Cellulitis/Abscess – Using ultrasound to determine the need for Incision & Drainage versus antibiotics and observation
  7. Gallbladder- detecting cholelithiasis and cholecystitis
  8. Fluid Status/IVC- estimating central venous pressure and performing serial exams to monitor fluid resuscitation in sepsis
  9. Aorta- Aneurysm
  10. FAST exam- Trauma, with identification of common fluid-filled cavities
  11. Renal- ruling out hydronephrosis
  12. IUP- finding an intrauterine pregnancy transabdominally, recognizing key structures, and obtaining a fetal heart rate.
  13. DVT- compression, augmentation, 2/3-point compression
  14. Central Venous Access- internal jugular, femoral, other
  15. RUSH (Rapid Ultrasound for Shock & Hypotension) exam- differentiating hypotension using ultrasound
  16. Ultrasound-guided injections and biopsies
  17. Thyroid irregularities (nodules, cysts, Hashimoto’s)
  18. Urinary retention

ECC Approved
November 2024

Last Updated: 12/10/24