Author: Jen Cochrane: EM Trainee
POCUS became a mandatory element of ED training in the UK and Ireland in 2010. Ireland is affiliated with RCEM UK and follow the same guidelines for training.
Here is the pathway in a nutshell
Step 1 Attendance to a level 1 course.
These cover the core physics basics of ultrasound and application for daily use. They should also include practical sessions for the four core applications:
- Focused Assessment with Sonography in Trauma (FAST)
- Assessment of the Abdominal Aorta for Aneurysm (AAA)
- Focused Echocardiography in Life Support (ELS)
- Ultrasound Guided Vascular Access
There are several running in the UK and as part of the BSTEM training programme RSCI runs a course for trainees several times a year. See list of courses for links.
Step 2. Completion of RCEM eLearning modules.
There are 6 online modules that cover ultrasound physics ect and supply a certificate at the end. These take 10-20mins to complete and the certificate is required for signoff. (Easier after a course!!)
- Ultrasound: Skills of ultrasound guided vascular access
- Ultrasound: Skills of carrying out Focused assessment sonography in trauma
- Ultrasound: Skills of carrying out abdominal aortic aneurysm assessment (AAA)
- Ultrasound: Physics and basic equipment settings
- Ultrasound: Indications for ultrasound
- Ultrasound: Image aquisition
Step 3. Create a Portfolio
Keep a portfolio of scans performed- easier said than done. Keeping picture evidence of scans performed as either printouts or electronic copies is essential. Ensure when you start you know how to do this on your local equipment otherwise it can prove time consuming and difficult putting together cases to write up. Eportfolio users can use reflective notes section to create a logbook in one place.
The more people you scan the better. Get to know what’s normal and how to adjust settings to get better images. The college used to ask for 10 AAA/FAST/Vascular access as a minimum. It’s a good start.
Step 4. Write up cases
10 cases including pictures should be presented at the finishing school. (appendix two of the core document)
Step 5 Finishing school
Attendance at a finishing school to show off your cases and ultrasound prowess is the final step for signoff as core (previous level 1) competent. They involve an OSCE style assessment by accredited assessors, and review of cases. It is mandatory for CCT of ED training.