Ultrasound Rotation

Hello!  

Welcome to your Emergency Ultrasound rotation! We are very much looking forward to having you. Please read the following carefully as it provides important details regarding your rotation. The rotation will begin on Monday of your rotation week at 9:00 a.m. and we will meet at the GW Department of Emergency Medicine administrative offices in the conference room on the 4th floor. If you haven’t done so already, please email your phone number to Ayshia Coletrane for any last-minute changes. The GW Department of Emergency Medicine administrative offices are located at: 

2120 L Street, NW, Ste 450 
Washington, DC 20037 

Quality Assurance Meeting/Orientation 

This is a required portion of the rotation. You will participate in our weekly quality assurance (QA) sessions every Monday during your rotation and monthly Journal Clubs if the journal club date falls within your rotation block.   

Hands-on Ultrasound Scanning 

You will need to sign up for seven 4-hour scan shifts/week (you will do this during your first day).  You will find this within the google calendar for the MFA Ultrasound Scanning Shifts. If you do not have access to the google calendar by the first day of the rotation, please contact Dr. Ogle or Ayshia. 4 shifts/week will be by yourself and if there are other rotators, you should all scan together. For the remaining 3/7 scanning shifts, you must pair up with a resident/fellow/faculty for at least part of the scan shift. Your scanning shifts will be arranged on the Monday of each week, as the faculty schedules are variable.   

QPATH Documentation 

If you are an EM resident, part of your responsibility during this rotation is to follow up on patients you have performed ultrasounds on, complete the worksheet within Qpath, add results of any confirmatory imaging or other clinically relevant information for review with faculty during the QA session. Your first scan shift will be on the first Monday afternoon following QA. You will not receive an evaluation for this rotation until your QPath documentation is up to date. 

Independent Learning Resources

We are recommending three different e-books for your personal ultrasound e-library and reference for the rotation:  

https://itunes.apple.com/us/book/introduction-to-bedside-ultrasound/id554196012?mt=11 

Introduction to Bedside Ultrasound: Volume 1 by Matthew Dawson & Mike Mallin on Apple Books 

and  

https://itunes.apple.com/us/book/practical-guide-to-critical-ultrasound-volume-1/id1439354416?mt=11 

Practical Guide to Critical Ultrasound, Volume 1 by Resa E. Lewiss on Apple Books 

and finally:  

https://itunes.apple.com/us/book/practical-guide-to-critical-ultrasound-volume-2/id1439371403?mt=11 

Practical Guide to Critical Ultrasound, Volume 2 by Resa E. Lewiss on Apple Books 

You should read the chapters covering physics as well as the FAST exam prior to the first day of the rotation. Other helpful chapters will be gall bladder, cardiac, OB, aorta and DVT.  

Online resource: for sonoguide https://www.acep.org/sonoguide/introduction.html 

2-week rotator will participate in: 

  • 8-10 hours of QA 
  • 56 hours of scanning 
  • +/- journal club 

4-week rotator will participate in: 

  • 16-20 hours of QA 
  • 112 hours of scanning 
  • +/- journal club 
  • 20 minute presentation on US topic of your choice to be delivered on the final Monday of your rotation 

Guidelines for solo scanning

Here's what we recommend for your "solo shifts." 

  • Do them in the afternoon as there are many more patients in the department getting imaging studies 
  • Only do ultrasounds of the body part that is already being imaged by CT scan or US (you can tell by looking at Cerner in the comment section for who's getting imaging studies) 
  • So, open Cerner, make a list of patients getting CT or US exams 
  • Introduce yourself to patients as medical students/residents on the ultrasound team. Tell them you noticed they are getting a CT scan or an US scan of a certain body part. Then ask their permission to do your own ultrasound to compare to the one they are already getting. Let them know this is part of your education and learning and they will not be charged for it. 
  • If you happen to see anything abnormal or strange, they are already getting a comprehensive radiology imaging study, so that will cover any abnormalities. 
  • If a patient is getting a CT Abdomen/Pelvis with contrast, (if the patient is amenable), you can do FAST, Gall Bladder, Aorta, Kidneys. If getting a non-contrast study, exclude the Aorta. 
  • If a patient is getting a pelvic sono (for pregnancy), you can do an OB US (make sure you're in the OB setting rather than the abdominal setting) 
  • If there are two of you scanning and you're going to do a FAST and GB, one of you should do the FAST, the other the GB. 
  • If you want to do a scan you've not done before, either refer to https://www.acep.org/sonoguide/introduction.html 

Or to do some self-directed learning with the Sonosite X-porte which has teaching modules within it. Explore the purple "Learn" tab by touching it and reviewing the different studies available under "Acute Care". 

The idea is that we do recommend you step outside of your comfort zone a little bit and work on your own skill development. It also enables us to give you some feedback during QA. If you do all of your scans with us, you get less feedback. 

US Section Faculty are: 

Keith Boniface 

Matt Pyle 

Aaran Drake 

Elizabeth Dearing 

Sarah Frasure 

Damali Nakitende 

Kat Ogle 

Current US Fellow is a Pediatric Ultrasound Fellow: 

Simone Lawson