Short Courses

Introduction of the fundamental principles of ultrasound and familiarisation with ultrasound machines. After this session candidates will be able to:

• Understand how an image is generated from sound and why certain tissues look different shades of grey on ultrasound
• Recognise the common ultrasound artefacts to assist in diagnosis
• Select the correct transducer/probe and settings for the required exam
• Implement the common conventions when scanning
• Correctly handle a probe and use the common functions and features of ultrasound machines
• Use tips to optimise their scans

The theoretical component is followed by a hands-on session during which candidates familiarise themselves with the scanning process, the various functions of the machine and learn to recognise some key anatomical structures to build a foundation for the rest of the course.

Identification and measurement of the abdominal aorta (AA) for recognition of an abdominal aortic aneurysm (AAA). After this session, candidates will be able to:

• Identify the aorta and its main branches in both tra
• Identify the surrounding structures including the Inferior Vena Cava (IVC) and vertebral bodies
• Measure the aorta and recognise an aneurysm and dissection
• Be aware of the limitations and pitfalls in scanning the aorta for AAA
• Use bedside US within recognised clinical pathways

The teaching component is followed by intensive practical sessions to ensure that candidates identify and measure the AA and its principal branches in both transverse and longitudinal planes.

Identification of free fluid in 4 anatomical spaces: right and left pleura, pericardium and peritoneum. After this session, candidates will be able to:

• Understand the key premise of FAST (Focused Assessment with sonography in Trauma)/FAFF (Focused Assessment for Free Fluid) scanning
• Acquire the 4 key views: Right flank, Left flank, suprapubic and subcostal.
• Implement useful tips to improve the image acquisition and sensitivity of the scan
• Recognise the limitations of the scan
• Recognise the evidence base for the use of FAST/FAFF

The didactic component is followed by intensive practical sessions to ensure that candidates learn to acquire the views, optimise their technique and perform a thorough evaluation of the spaces. The candidates will also run through a series of case studies to assist in the integration of the scan within a clinical context.

Evaluation of the IVC to assist in the evaluation of hypovolemia and shock. Assessment of the lung for identification of pneumothorax (PTX). After this session candidates will be able to:

• Understand the rationale for using the IVC in the assessment of hypovolemia and the need for fluids
• Measure the maximum and minimum diameter and calculate the collapsibility index of the IVC
• Recognise the limitations of using IVC for diagnosis of hypovolemia and shock
• Integrate measurement of the IVC with ECHO in the diagnostic pathway of shock
• Recognise the evidence base for the US assessment of IVC in hypovolemia and shock
• Assess the pleural structures
• Understand the premise and rationale for using US in the diagnosis of PTX
• Identify Lung Sliding and its absence
• Identify a PTX and Lung Point
• Recognise the evidence base for US diagnosis of PTX

The didactic component is followed by a practical hands-on session.

Evaluation of the heart using the Parasternal long and short axis views as well as the apical 4 chamber view. After this session teh candidates will be able to:

• Appreciate the evidence base for bedside ECHO
Recognise the clinical situations in which ECHO may assist them
• Implement scanning conventions for ECHO
• Position the patient for optimal images
• Acquire the parasternal long axis (PLAX) and short axis views
• Acquire the Apical 4 chamber view
• Utilise a structured diagnostic approach to evaluate the heart
• Diagnose decreased LV contractility and dilated LV suggestive of heart failure: dilated aortic root suggestive of aortic dissection, dilated RV suggestive of PE; presence of a pericardial effusion and recognise features of cardiac tamponade.
• Appreciate the limitations of a focused scan.

The session is divided into 2 parts each having a didactic and practical session. In addition, the candidates will go through a number of case studies to integrate ECHO within a clinical context.

Use of ultrasound to guide vascular access (serves as a basis for all ultrasound guided interventions). After this session the candidates will be able to:

• Appreciate the evidence base for US guided central and peripheral access
• Recognise and differentiate veins and arteries
• Recognise other adjacent structures including muscles, tendons and nerves
• Use an approach for scanning the upper limb veins for peripheral access
• Select the most appropriate vein for cannulation to ensure success, using specific criteria
• Use both in-plane and out-of-plane techniques for cannulation
• Confirm successful cannulation using ultrasound

The didactic session is followed by 2 practical sessions during which the candidates will:
1. Familiarise themselves with the sono anatomy of the key sites and apply criteria for choosing the right vein
2. Perform both in-plane and out-of-plane cannulation techniques on ultrasound phantom blocks.

Use of an US protocol integrating all the modalities learnt in the course, to evaluate the patient with undifferentiated shock. After this session the candidates will be able to:

• Appreciate the evidence base for shock scanning
• Incorporate ultrasound in diagnostic work up of the shocked patient
• Perform an ultrasound shock protocol

The didactic session is followed by a case based practical session to allow candidates to revise and re-practice the modalities learnt on the course whilst incorporating them into a clinical diagnostic approach.