Page 1 : Introduction

 2024 

Updated POCUS training Whangarei Emergency Department 

Ultrasound lead : Mick Killeen , FACEM 

Bedside ultrasound training has evolved in Emergency Medicine over the course of the last decade. 

ACEM has moved away from prescribed credentialing based on other organisations (eg ASUM ) and formally credentialed workshops and courses . The guidelines can be accessed on the side bar of this blog. To summarise ACEM and the Ultrasound steering committee have made the following recommendations: 

1) Credentialing of POCUS is the responsibility of the local hospital and health organisation , not ACEM 

2) The traditional stepwise process of training is maintained but there is no governing body outside ACEM , although organisations such as ASUM are recognised  sources of reference and training . The training steps are outlined below 

3) Ongoing maintenance of credentialing involves continuined practice  of the various POCUS modalities +/- logging of this . 

Stepwise POCUS training  

1. Workshop attendance . There are various resources such as the eBooks Introduction to bedside ultrasound vol 1 and 2 , Websites such as POCUS 101 , Sonomojo.org will lead you modules that are easy to access and understand . Coreultrasound.com is also to be recommended . Although workshop attendance should be 2 hrs per module , this time can be greatly reduced by accessing the websites and resources above . We feel that didactic one on one instruction during the six months a trainee is in Whangarei hosptial , they should be able to get sufficient teaching if they also use these free online resources 
2. Log scans ( for most modules , the required number to log is 15 ( 25 for EFAST and 50 for cardiac )  At least 2 of these logged scans in a module must be supervised with feedback ( these are called formative scans ) .There needs to be some positive pathology demonstrated on some of the images  . Many of the images can be obtained outside the clinical setting eg , at a course 
3. On completion of at least the majority of the log book,  an “exit” or “ summative scan” should be supervised and signed off , completing the initial training process . Examples of what a summative scan looks like can be seen by following the link to ASUM and scrolling through the details of each module to the end . 
4. Ongoing maintenance of POCUS skills involves continued logging of images . 

In the up coming posts I will review  the details of each of the modules 

The following are recommended apps for logging images although a simple excel or google sheet would also suffice .

Echo log 

Tidy ultrasound 

The following posts will run through various scanning protocols , in particular focussed cardiac echo , early pregnancy , hepatobiliary and soft tissue / small parts / MSK ultrasound at the point of care. It is up to the reader to look at various resources on the side bar to learn some of basics ( eg POCUS 101 and introduction to beside ultrasound Vol 1 / 2 ) . The next step is to gets someone on the “shop floor” to give you some  instruction and then get some formative scans supervised ( see forms attached to each module )  and then a final summative scan demonstrating competency . 

A summative scan demonstrates competency , a log book with required scans confirms credentialing requirements. Without credentialing it is difficult to report on a POCUS scan without a supervisor present and it is to be discouraged . 

LINK TO INTRODUCTION TO BEDSIDE ULTRASOUND VOLUME 1 

LINK TO POCUS 101 

PLEASE FOLLOW LINKS ON SIDE BAR FOR MORE USEFUL LINKS