Transcription

1 ULTRASOUND IN PEDIATRIC & NEONATAL EMERGENCY & CRITICAL CARE PEDIATRIC & NEONATAL CRITICAL ULTRASOUND BASIC LEVEL 1 PROVIDER [PNCUS- BL1P] March th, 2015 BANGKOK, THAILAND First Announcement 1

2 WINFOCUS (World Interactive Network Focused On Critical UltraSound) The world leader scientific organization committed to develop point-of-care ultrasound practice, research, education, technology, and networking, addressing the needs of patients, institutions, services, and communities in critical scenarios. WINFOCUS Vision and Mission Statements Improving Primary, Emergency, and Critical Care Medicine, by incorporating "point-of-care" Ultrasound into Clinical Practice bringing quality Point-of-care Ultrasound to the patient in all out-of-hospital and in-hospital critical scenarios, by developing and fostering, on a global and multi-disciplinary basis, Ultrasound Education, Technological Development, Evidence-based Research, and International Teamwork. COURSE DIRECTOR Mahmoud Elbarbary (Riyadh, KSA) COURSE CO-DIRECTOR Rujipat Samransamruajkit, MD. (King Chulalongkorn Memorial Hospital) COURSE FACULTY Ghassan Shaath (Riyadh, KSA) Abdelraouf Jejah (Riyadh, KSA) Etc. Chalermthai Aksilp, MD. (Queen Sirikit National Institute of Child Health) COURSE FORMAT 2-days course with interactive lectures & case scenarios HOT (hands-on Training) on manikins, phantoms and human volunteers ABCDE & Head-to-Toes conformed. Limited to 32 participants End of Course & Certificate from WINFOCUS VENUE: Or Por Ror Building King Chulalongkorn Memorial Hospital Bangkok, Thailand Contact: Rujipat Samransamruajkit, MD; Rujipat.S@chula.ac.th Chalermthai Aksilp, MD; dr.aksilp@gmail.com Registration FEES: Before Feb. 15, 2015 After Feb. 15, 2015 Country Cat A 350 Euro 400 Euro Country Cat B, C include Thailand 200 Euro/ 8,000 Baht 250 Euro/ 10,000 Baht Registration Contact: Mr.Nondh Ningsanond (นายนนท น งสานนท ) Wild Blue Company, 19/2 Ekamai 10, Sukhumvit 63, Wattana, Bangkok 10110, Thailand. Tel: Fax:

3 CRITICAL ULTRASOUND The concept of 'critical ultrasound' evolved recently from 'emergency ultrasound' performed at the 'point-of-care' in scenarios such as emergency departments, ICUs, pre-hospital care, austere environments, disaster scenes, tactical operations, and humanitarian care missions. Clinical scenarios turn into 'critical' ones when there is a dangerous performance gap between the patient status and the resources available for an appropriate decision making and problem solving. In such settings ultrasound point-of-care image acquisition and interpretation, integrated with advanced life support protocols (ACLS, ATLS) according 'ABCDE' and 'Head-to-toes' -type approaches, allows for rapid and effective decision making, enhanced triage, diagnosis, therapy, monitoring, and follow up. Nowadays, that s approach is also known as Ultrasound Life Support. This typically occurs in the acutely ill patient (Emergency US) or intensive (Intensive/Critical Care US), and/or where human or technical resources are particularly limited (Screening US, Triage US, Remote US, Primary US). 3

4 WORKSHOP PROGRAM - DAY 1 (Thursday, March 19, 2015) REGISTRATION 09:00-09:15 Introduction: Concept of Pediatric Critical US 09:15-09:45 US physics & Knobology Elbarbary 09:45-10:30 Basic Echocardiography Normal & abnormal Shaath 10:30-11:00 Lung US: Normal and pathologic findings by US from A-Z/ simulation Elbarbary 10:45-11:00 COFFEE BREAK 11:00-11:30 US Vascular catheterization general considerations 11:30-12:00 US Vascular catheterization special considerations Jejah Jejah 12:00-13:00 LUNCH BREAK 13: HOT (Hands-On Training) 6 machines 2 stations Each ECHO Chest Vascular/foreign body 2 trainers Shaath-TBA Elbarbary - Rujipat Chalermthai -TBA 13:00-15:00 1 & 2 3 & 4 5 & 6 15:00-17:00 5 & 6 1 & 2 3 & 4 17:00-19:00 3 & 4 5 & 6 1 & 2 END OF DAY 1 In the first HOT session, the first 10 min to be given for knobology orientation After the second HOT session, to give 10 min break 4

5 WORKSHOP PROGRAM - DAY 2 (Friday, March 20, 2015) 08:30-09:00 REGISTRATION 09:00-09:30 Wrap up & Feedback M Elbarbary 09:30-10:00 Abdominal US & Trauma/simulation Shaath 10:00-10:30 Other US guided procedures (LP, pericardial and pleural peritoneal drainage) 10:30-11:00 More US in PICU/ER ( Vocal cords, Trachea & Diaphragm & head Doppler& Neuro US) Jejah TBA 11:00-11:30 Muecloskeletal US and nerve block TBA 11:30-12:00 Critical US Enhanced Management Scenarios ABCDE algorithm- Simulation TBA 12:00-13:00 LUNCH BREAK HOT (Hands-On Training) 6 machines 2 stations Each Abdomen/muscloskeletal Airway/ ECHO Vascular/Neuro Shaath-TBA Elbarbary - TBA TBA 13:00-14:30 1 & 2 3 & 4 5 & 6 14:30-16:00 5 & 6 1 & 2 3 & 4 16:00-17:30 3 & 4 5 & 6 1 & 2 17:30-18:00 Winfocus training & accreditation process All END OF DAY 2 5

6 6

7 Credentials for Basic level 1 Provider I. Provider (BL1) Course attendance (2 days) 1. PNCU course 1-2 of May Please attach copy of certificate of attendance II. Practice within 3-6 month after the course 3. Total US Exams : 200 exams over 3-6 months 4. Population: on actual patient at least 50% of exams(=100). Rest can be on simulated patients/simulators 5. Settings : critical areas (ICU, ER, OR, Field triage.etc) 6. Review: Real-time (>30% = >60 exam) & delayed/offline (<70 %) 7. Frequency: 5-10 exams/week; inactivity less than <1 month 8. Time : average 50 hours for Basic level in 3-6 month 9. Clinically indicated: at least 50% = 100 exams 10. Pathologic findings: at least 10% = 20 exams 11. US Exams in key-competences(see tables & syllabus ): at least 15 Exams III. Logbook exams logged (within max 6 months) exams should be on real patient exam should be interpreted real-time exams should have pathology exams should have Recorded by pics or loops 17. At least 10 exams pathology Recorded by pics or loops 18. For the whole 200 Exams index page should be in the front page contains o Exam Serial number o Exam date o Finding o Records/documentation 19. Each of the 200 Exams the following entries are required: a. Exam serial number b. Date c. Setting (specify the clinical area) d. Population (patient (MRN) or simulation) e. Clinical indication (if patient) f. Review (offline/real-time) g. Finding h. Action/management (if patient) 7

8 IV. Test day & final credentialing 1) AIM of final test to evaluate each candidate performance on: a) image generation & acquisition b) image interpretation c) Image administration d) clinical ultrasound findings integration into clinical decision making and management e) optional research, teaching and administrative skills (for future instructors) 2) Test Process: a) Sonographic videoclip(loop) (15 min) interpretation of pathology b) Practical (at least ultrasound 3 loops) examination (30 min) on patients/volunteer Focus on image generation & acquisition by different windows and views Will include ABCDE c) Oral test (15 min) Case study presentation of 3 of the logged cases At least one clinical scenario (shock- hypotension etc) with questions about use of US exam integration in the management e) Multiple choice question MCQ test (30 min) 25 MCQ Each has 3-4 answers Performance required >75% Test both decision making and theoretical knowledge Important documents: 1. USCMC SYNOPTIC TABLES 2. Syllabus 3. Sample of logbook 8

9 9

10 10

11 11

12 USCMC CERTIFICATION ~ USLS BL1 & AL1 for PROVIDERS 12

13 USCMEC GLOBAL PROGRAM DIRECTORS: Luca Neri (Milan, Italy): Chair Richard Hoppmann (Columbia, SC, USA), Enrico Storti (Milan, Italy): Co-chairs Supported by: Michael Blaivas (Atlanta, GA, USA): Winfocus President, RESCUE & ILCEUS Chair Daniel Lichtenstein (Paris, France): Winfocus Scientific Comm. Chair USCMC LEARNING CONTENTS and FORMAT : The applications targeted in the USCMC (Ultrasound Critical Management Certification) program rely on the most recent literature and recommendations, and refer mostly to the Critical Care Medicine Journal Supplement fully dedicated to the ultrasound applications in the acute and critical patients (Crit Care Med 2007;35[Suppl]), written by a few dozens of the actual major world experts in the field, coordinated by Blaivas, Kirkpatrick and Sustic, and mostly involved in the Board of WINFOCUS. Proposed educational formats and pathways refer to a working document, published in its earliest version in the same supplement (Neri L, Storti E, Lichtenstein D, Toward an ultrasound curriculum in critical care medicine. Crit Care Med 2007;35[Suppl]:S290 S304), starting point of an International evidence- and consensus-based process, join to the USCME and ILCEUS projects (please, see details in USCMC EDUCATIONAL CERTIFICATION ROADMAP : Certification steps are implemented along the three EFSUMB levels of proficiency ( Level 1 (BL1 & AL1, Basic and Advanced) - Common, general, focused competency Level 2 (BL2 & AL2, Basic and Advanced) - Comprehensive, specialized competency Level 3 (beyond standards, still to be defined) - Outstanding clinical, educational, research expertise Each level includes Provider and Trainer competence-based modules (see below as ex. the USCLS roadmap): ULTRASOUND LIFE SUPPORT: USLS BL1 Provider >> Trainer ( ABCDE conformed, non-specialty-specific, general) USLS AL1 Provider >> Trainer ( Head-to-Toes conformed, setting/specialty-specific, general) USLS BL2 Provider >> Trainer (Problem-based, setting/specialty-specific, specialized) USLS AL2 Provider >> Trainer (Organ/District-based, setting/specialty-specific, sub-specialized) Ex. ECHO-AL2 Provider >> Trainer (Advanced Echo-Doppler in ICU competences) According specific performance needs, several Level 1 and 2 (L1, L2) UltraSound Life Support and Procedural modules are available, both for Providers and Trainers (P, T): US-TLS (US Trauma Life Support) EFAST (Extended Focused Assessment with Sonography for Trauma) US-ACLS (US Advanced Cardio-pulmonary Life Support) US-PALS (US Pediatric Advanced Life Support) US-PHLS (US PreHospital Care & Disaster Medicine Triage) US-Triage (US Triage in Disaster Medicine) US-SEPS (US Sepsis Management) ECHO ICU (Echocardiography for Intenisivists) US-MON (US ABCDE Monitoring) US-GPE (US General Practice in Emergency) US-NURSE (US Nursing care in Emergency) US-PHC (US Primary Health Care in scarce-resource-setting) US-AIR (US Airway Management) US-CVA (US Central Vascular Access Management) US-PVA (US Peripheral Vascular Access Management) US-BLOCK (US-guided Nerve Blockage) Note: USCLS BL1 Certification includes US-TLS, US-PHLS, EFAST, US-BLS, US-ACLS credentialing. Each certification module is developed along three learning phases and a final examination: Part Ia: preliminary e-learning (lectures, interactive sessions, references) Part Ib: 1-2 days introductory course (theory, hands on, and simulation components) Part II: 1-6 months proctored practice (specific minimal requirements) Part III: 1 day credentialing examination (presentation, questionnaire, simulation-based practice) Each credential profile undergoes maintenance and quality assurance processes: Refresh: 1-2 day course (every 2 years; specific annual minimal requirements) USCME AUDIENCE TARGETS : - Health care professionals: Physicians, Nurses, Paramedics, Midwives, and Technicians working in - Critical scenarios: EM, CCM/ICU, Acute/Trauma Surgery, HEMS/EMS, PHC, Pediatric, Sport, Tactical, Remote, Rural, Wilderness, Scarce-resource settings. Further details at 13