Core Ultrasound Skills in Intensive Care

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/

ModalitiesEchocardiography

Focused Intensive Care Echocardiography (FICE)

British Society of EchocardiographyLung Ultrasound

BLU Protocol(British Thoracic Society)

Abdominal Vascular

ECHOCARDIOGRAPHY

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

FICE scans5 Views

Parasternal long axis Parasternal short axis Apical 4 chamber Subcostal Pleural fluid

6 questions Is LV significantly impaired? Is LV dilated? Is RV significantly dilated or

impaired? Is there pericardial fluid? Is there evidence of

hypovolaemia? Is there pleural fluid?

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)

Training the trainerModules will evolve

Other US modalitiesReaccreditationMaintain your skills

Life long learning

To deliver high quality US training, you need…

Clear objectives

Brilliant faculty and colleagues

Do it properly

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