email 2024-09-23

Point of care ultrasound has now been imbedded into the new RCEM curriculum and starts at ACCS.
There are 6 modalities that need to be completed at specific stages in your training.

ACCS
    •    Ultrasound Guided Vascular Access (VA)

• Ultrasound guided Fascia iliaca blocks

Intermediate

• Focused Assessment with Sonography in Trauma (FAST)

    •    Assessment of the Abdominal Aorta for Aneurysm (AAA)
    •    Focused Echocardiography in Life Support (ELS)
Higher

• Shock assessment

You will need to demonstrate competence in these modalities as you move through your training.

In order to achieve competence in each modality you will need to:

• Complete the relevant RCEM learning modules

• Attend a practical teaching session 

• Evidence your practice by compiling a logbook (suggested minimum number of scans per modality)

• Evidence your learning by use of reflection (5 reflections per modality minimum)

• Demonstrate competence with a DOPS assessment by a qualified supervisor.​

The Full RCEM guidance can be found HERE and at the RCEM ultrasound Webpage HERE

Completing the learning modules on RCEMlearning.
There are 9 modules and provide you with a certificate on completion. (Below are hyperlinks to the modules)
Ultrasound basics and image optimisation:
Ultrasound: Indications for ultrasound
Ultrasound: Physics and basic equipment settings
Ultrasound: Image acquisition
POCUS for ACCS:
Ultrasound: Skills of ultrasound guided vascular access
Ultrasound: Facia iliaca block
POCUS for Intermediate:
Ultrasound: Skills of carrying out focussed assessment in trauma (FAST)
Ultrasound: Skills of carrying out abdominal aortic aneurysm assessment (AAA)
Ultrasound: Echo in life support
POCUS for HST
Ultrasound: Assessment of patients in shock

Attending a course.
We will be running a yearly FUCEM (Focussed Ultrasound Course for Emergency Medicine) course in the peninsular region Please keep an eye on your inboxes for dates for the next one.

Many other courses are run across the country but they can be difficult to track down and are very popular.
The RCEM run a course from time to time, check Here to see if there are any upcoming study days.
Bromely Courses are popular as they are run regularly throughout the year. Click Here to look at their upcoming dates.

Supervised practice
Once you have completed your practical teaching and gained the theory from the modules it’s now time to put your learning into practice. You should contact your department ultrasound lead who can discuss how to achieve supervision safely in the department. You can scan without being directly supervised but you should be saving your images for review by a level 1 accredited trainer.

Please read your departmental ultrasound governance document if your department has one. You may discover incidental findings whilst scanning and these need to be managed appropriately. If you have any concerns about a finding or a patients scan when you are unsupervised please discuss this with the consultant on the day.

Keeping a logbook and Reflecting on your practice
You will need to log all your scans and build up evidence demonstrating that you are achieving competence. This is best achieved by using the Kaizen portfolio. Clearly the more you practice the better you will get and you need to amass a logbook with an indicative number of scans to demonstrate this. You will also need to reflect on some of your cases, highlighting how the use of ultrasound helped your clinical decision making and how you optimised your image/what you could differently to improve your image for example. The requirements of the indicative numbers for each of these can be found below:

DOPS assessment.
Much like demonstrating competence in other practical skills in emergency medicine you will need to complete DOPS assessments throughout your training. By the end of your training you will need to achieve entrustment level 4 in each modality but throughout your training you will have assessments graded at lower entrustment levels. The expectation for each entrustment grade can be found in the full RCEM guidance to which there is a link above.  Over time you will thus demonstrate development through the entrustment levels and finally achieving level 4.