The overall goals of this 2-week advanced POCUS rotation are to:

• Become proficient in bedside image acquisition and interpretation in core applications of POCUS, and reliably integrate ultrasound into clinical practice. This includes meeting criteria for POCUS certification in at least 6 core emergency ultrasound applications as defined by ACEP.  

  • • Required applications are:

      • • Echo (25-50 scans logged)

        • EFAST  (25-50 scans logged)

        • US-guided vascular access (minimum 5 scans logged)

        • At least 3 other diagnostic POCUS applications of your choice (25-50 scans of each type logged).  

    • Doing more than this minimum is recommended!  It will allow you to be eligible for privileging to perform more POCUS in your EM practice after residency.
      
      

• Develop knowledge and skill in the remaining core POCUS applications:

  • • First trimester pregnancy

    • DVT

    • Ocular

    • Soft Tissue

    • MSK

    • Bowel

ROTATION REQUIREMENTS

• The POCUS rotation is a clinical rotation, and scheduling of other commitments (e.g. Step 3, personal) during the US rotation must be approved in advance by the US faculty.  The rotation is designed to be flexible, and we can usually accommodate if you let us know in advance.  In general, the resident should plan to scan in the ED from Monday-Friday for at least 4-6 hours a day to be able to meet rotation requirements.  Your independent scan shifts are self-scheduled and can take place anytime, as long as rotation requirements above are met.

• EM residents must attend resident conference every Friday morning

Requirements for Graduation

Your goal should be to attain credentialing in all 15 core POCUS applications by the end of residency.  However, credentialing in a minimum of 6 applications is required for graduation from the Hopkins EM residency.  This is usually achieved by the end of the Advanced POCUS rotation.

To become POCUS credentialed, the resident must participate in didactic and experiential learning, complete a minimum number of logged scans, and have proficiency assessed objectively.

1.     Didactics:

• 8-hour orientation during intern US bootcamp

• Lectures during Friday resident conference and weekly US meetings 

• Assigned readings and interactive multimedia education

2.     Experiential

• Hands-on sessions during resident conference

• Supervised and independent scanning during ultrasound rotation, ED clinical shifts, and off-service rotations

• Perform at least 150-300 ultrasound exams, with >25 approved scans in 5 diagnostic applications (including FAST and echo) and >5 US guided vascular access procedures

• Though credentialing in at least 6 POCUS application is required, completing more will allow you broader practice and privileging in ultrasound when you graduate to a staff/attending role!

3.  Competency Assessment:

• Assessment of US technique via direct observation and/or OSCE/SDOT (completed during POCUS rotations)

• Assessment of image quality and interpretation via QA review of resident ultrasound scans

• Standardized written/online examinations (SAEM ultrasound exams)

EDUCATIONAL RESOURCES AND OTHER ROTATION DOCUMENTS

End-of-Rotation Checklist - Advanced US Rotation - submit to Dr. Fong at end of rotation

US measurements pocketcard - save to Evernote or Dropbox for quick reference!

Many more educational resources and references 

ULTRASOUND ROTATION CALENDAR