Department of
Internal Medicine at Highland Hospital
A member of Alameda Health System

Ultrasound Pathway


Objectives

To develop basic and advanced skills in point of care ultrasound (POCUS) via:

  • Self directed reading articles, viewing of videos, listening to podcasts, attending journal clubs and image review, and bedside scanning
  • Understand the basics of how ultrasound works and the clinical utilities
  • Participate in scanning sessions with internal medicine, critical care, cardiology, and emergency medicine faculty
  • Create an ultrasound image database
  • Participate in poster or research presentations at local and national conferences
  • Option to attend POCUS conferences held throughout the country

Curriculum

There are three major components for the Ultrasound Pathway, electronic learning, skills practice, and evaluation.

Learning assignments summary

R2

  • Learn basic ultrasound physics and image acquisition with evaluation of images
  • Review of CHEST Ultrasound Videos
  • Review ECHO masterclass from 123sonography
  • Participate in online journal club with other members of the pathway
  • Compilation of ultrasound bibliography
  • Attend 5 ED Journal Clubs on Thursday mornings each year
  • Attend (and teach if applicable) at Intern Bootcamp, ECHO bootcamp, and other ultrasound events at Highland throughout the year as residency schedule permits.
  • Create an ultrasound quiz related to teaching topics
  • Present a poster or research at a regional or national conference

R3

  • Complete Portfolio of video images
  • Assist in updating and building the Highland POCUS curriculum
  • Agile MD
  • Quizzes
  • Faculty bootcamp
  • Teaching POCUS rounds to other residents and faculty
  • Availability to scan for wards and ICU team
  • Teach a 1-2 hour academic half day to fellow residents
  • Present a poster or research at a regional or national conference
  • Create an ultrasound quiz related to teaching topics
  • Attend 5 ED Journal Clubs on Thursday mornings each year
  • Attend (and teach if applicable) at Intern Bootcamp, ECHO bootcamp, and other ultrasound events at Highland throughout the year as residency schedule permits.

Optional

Attend a live POCUS course (this is easily researched online, but contact faculty prior to committing to a course)
Participate in ultrasound research project
Grant writing for research and equipment proposals

Skills summary

  • Independent scanning in acute care hospital, outpatient clinics, and ED
  • 2 hour faculty scanning sessions* (4 total)
  • ED scanning shifts (4 total)
  • ICU scans with ED resident* (2 total)
  • Cardiology scanning with Dr. Barbant* (2 total)

    * Please schedule these sessions with the faculty at least 1 week prior to planned date.

Portfolio of Video Images- 2 year goal

A large portion of the pathway will be spent on independently obtaining video images. You will be instructed on how to save and download ultrasound images on a USB drive to collect and review your ultrasound images with faculty. The requirement for successful completion of the pathway is listed below. The lead faculty will determine whether the images are adequate to be included in your portfolio. Different types of pathology are not necessary unless noted specifically. For example you do not need to obtain images of an actual DVT, but you do need to show a pleural effusion.

Requirements for Portfolio Image Collection

Cardiac Study (10 studies with the following images per study)
Total: 50 images
Parasternal long axis view
Parasternal short axis view
Apical four-chamber view
Subcostal long axis view
Inferior vena cava longitudinal view

Lung/Pleural Study (4 studies with the following images per study)
Total: 12 images
Pleural effusion (any size)
Sliding lung
Consolidation

Abdominal Study (4 studies with the following images per study)
Total: 20 images
Left kidney longitudinal view with splenorenal space
Right kidney longitudinal view with hepatorenal recess
Abdominal aorta longitudinal view
Gallbladder transverse view
Bladder transverse view

Vascular Diagnostic DVT Study (3 studies with the following images per study - include right and left legs)
Total: 24 images
Right common femoral vein with compression
Left common femoral vein with compression
Right common femoral vein at saphenous intake with compression
Left common femoral vein at saphenous intake with compression
Right superficial femoral vein with compression
Left superficial femoral vein with compression
Right popliteal vein with compression
Left popliteal vein with compression

Vascular Internal Jugular and Subclavian (3 studies with the following images per study - include right and left sides)
Total: 12 images
Right IJ with compression
Left IJ with compression
Right Subclavian in transverse view with lung apex visible
Left Subclavian in transverse view with lung apex visible

Total Images: 118