The PoCUS Course

Introduction to Pre-Hospital Trauma Ultrasound On this One Day course participants will be exposed to how Point of Care Ultrasound can impact clinical decision making in the acutely injured trauma patient.

Course Description: On this course participants will be exposed to how Point of Care Ultrasound can impact clinical decision making in the acutely injured trauma patient.  The course covers a range of topics including:

  • Introductory ultrasound operation and use
  • The eFAST exam (extended Focused Assessment with Sonography for Trauma) which is used to assist in detecting intra-abdominal bleeding, Cardiac Tamponade, and Haemo/Pneumothorax
  • An approach to clinical integration of Ultrasound findings in trauma patients specific to the Pre-hospital environment.

Participants will gain a new and exciting appreciation for how ultrasound can enhance clinical decision making, the actual relative anatomy of internal organs in live patients, and the benefits and limitations of ultrasound examination informed by the latest literature and evidenced based practices. Unlike traditional ultrasound courses, this course is specifically designed for the challenges of the Pre-Hospital environment. The Introduction to Pre-Hospital Trauma Ultrasound Course is ideal for Paramedics, Foundation and Core Training Doctors, and Trainee Practitioners interested in PHEM, who haven’t yet undergone formal ultrasound training.  It’s also a fantastic refresher for clinicians who want to become more confident in their basic emergency ultrasound skills.

Assessment:
Attendees will be examined using a combination of observed / supervised scans and written multiple choice testing.  Pre-Course, Formative, and Summative examination is used. All attendees will be given a certificate of attendance. Attendees who are felt to have demonstrated skilled scanning and clinical integration of sonographic findings above the expected level of performance will also be offered a certificate of merit. Course Package: Attendees will receive:

  • Pre-course educational package
  • Course Certificate of Attendance on Completion
  • Trauma Ultrasound Action Card / Cognitive Aid Tool

Learning Outcomes: Physics and Technology

  • Demonstrates understand the basic physics of ultrasound imaging
  • Uses this knowledge to detect and interpret basic artefacts such as;
    • posterior acoustic enhancement
    • acoustic shadowing
    • reverberation artefact
    • ring-down artefact
    • mirroring

Clinical Integration

  • Understand how POCUS can be safely integrated into clinical decision making in the unwell trauma patient; with a focus on;
    • Demonstrating safe practice through an understanding of the limitations of POCUS examination and the test characteristics of the components of the eFAST exam.  Including a rule-in philosophy in interpretation of gross pathological findings and by understanding the sensitivity and specificity of the Lung, Cardiac, and Abdominal components of the exam.
    • Demonstrate an ability to safely integrate this knowledge into clinical decision making in the un-well trauma patient
    • Reason and clinically integrate pathologic and/or inconclusive findings in scenarios and/or case discussions

Lungs

  • Acquire and Interpret lung ultrasound findings for detection of significant pneumothorax
  • Acquire and Interpret lung ultrasound findings for detection of significant pleural fluid
  • Understand the clinical implications of these findings

Cardiac

  • Acquire basic echocardiographic views in the Subcostal and Parasternal Long Axis
  • Interpret basic echocardiographic views in the Subcostal and Parasternal Long Axis for detection of pericardial fluid
  • Qualitatively asses pericardial fluid and identify associated features of tamponade, such as right ventricular diastolic collapse
  • Understand the clinical implications of these findings

Abdominal / Peritoneal

  • Acquire and interpret sonographic images as part of a ‘FAST’ exam for the detection of abdominal /peritoneal free fluid
  • Demonstrate proper scanning technique by fanning through the entirety of the structures being examined

Obtain and interpret sonographic views of the Right Upper Quadrant in the context of the eFAST that include:

  • Correct identification of the Lung Interstitia, Spinous Processes, Diaphragm, Liver, and Kidney
  • The communication of the Lung, Diaphragm, and Liver
  • The caudal tip of the liver
  • The Hepatorenal potential space

Obtain and interpret sonographic views of the Left Upper Quadrant in the context of the eFAST that include:

  • Correct identification of the Lung Interstitia, Spinous Processes, Diaphragm, Spleen, and Kidney
  • The communication of the Lung, Diaphragm, and Spleen
  • The Potential space between the diaphragm and the spleen
  • The Splenorenal potential space

Obtain and interpret sonographic views of the Pelvis in the context of the eFAST that include:

  • Identification of the Urinary Bladder, Prostate and seminal vesicles (in males) and uterus (in females)
  • The potential spaces; below, above, and lateral to the urinary bladder where free fluid may collect

Principles of Ultrasound Use

  • Demonstrates safe practice through proper documentation and labelling
  • Demonstrates knowledge of basic infection control procedures and principles
  • Demonstrates Knowledge of associated risks to provider and patient.

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