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Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management.

Killu K, Coba V, Mendez M, Reddy S, Adrzejewski T, Huang Y, Ede J, Horst M - Crit Care Res Pract (2014)

Bottom Line: New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720).Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.

ABSTRACT
Objectives. This study was designed to assess the clinical applicability of a Point-of-Care (POC) ultrasound curriculum into an intensive care unit (ICU) fellowship program and its impact on patient care. Methods. A POC ultrasound curriculum for the surgical ICU (SICU) fellowship was designed and implemented in an urban, academic tertiary care center. It included 30 hours of didactics and hands-on training on models. Minimum requirement for each ICU fellow was to perform 25-50 exams on respective systems or organs for a total not less than 125 studies on ICU. The ICU fellows implemented the POC ultrasound curriculum into their daily practice in managing ICU patients, under supervision from ICU staff physicians, who were instructors in POC ultrasound. Impact on patient care including finding a new diagnosis or change in patient management was reviewed over a period of one academic year. Results. 873 POC ultrasound studies in 203 patients admitted to the surgical ICU were reviewed for analysis. All studies included were done through the POC ultrasound curriculum training. The most common exams performed were 379 lung/pleural exams, 239 focused echocardiography and hemodynamic exams, and 237 abdominal exams. New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720). Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435). Conclusions. Implementation of POC ultrasound in the ICU with a structured fellowship curriculum was associated with an increase in new diagnosis in about 2/3 and change in management in over 1/3 of ICU patients studied.

No MeSH data available.


Related in: MedlinePlus

POCUS exams performed by the ICU fellows during a one-year academic period.
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Related In: Results  -  Collection


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fig1: POCUS exams performed by the ICU fellows during a one-year academic period.

Mentions: The most common exams performed were 379 (43.41%) lung and pleura exams, 239 cardiovascular exams (including the limited echocardiography and hemodynamic assessment) (27.37%), and 237 abdominal exams (including FAST, gallbladder, general abdomen, and pelvis) (27.14%) (Figure 1).


Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management.

Killu K, Coba V, Mendez M, Reddy S, Adrzejewski T, Huang Y, Ede J, Horst M - Crit Care Res Pract (2014)

POCUS exams performed by the ICU fellows during a one-year academic period.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4248397&req=5

fig1: POCUS exams performed by the ICU fellows during a one-year academic period.
Mentions: The most common exams performed were 379 (43.41%) lung and pleura exams, 239 cardiovascular exams (including the limited echocardiography and hemodynamic assessment) (27.37%), and 237 abdominal exams (including FAST, gallbladder, general abdomen, and pelvis) (27.14%) (Figure 1).

Bottom Line: New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720).Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.

ABSTRACT
Objectives. This study was designed to assess the clinical applicability of a Point-of-Care (POC) ultrasound curriculum into an intensive care unit (ICU) fellowship program and its impact on patient care. Methods. A POC ultrasound curriculum for the surgical ICU (SICU) fellowship was designed and implemented in an urban, academic tertiary care center. It included 30 hours of didactics and hands-on training on models. Minimum requirement for each ICU fellow was to perform 25-50 exams on respective systems or organs for a total not less than 125 studies on ICU. The ICU fellows implemented the POC ultrasound curriculum into their daily practice in managing ICU patients, under supervision from ICU staff physicians, who were instructors in POC ultrasound. Impact on patient care including finding a new diagnosis or change in patient management was reviewed over a period of one academic year. Results. 873 POC ultrasound studies in 203 patients admitted to the surgical ICU were reviewed for analysis. All studies included were done through the POC ultrasound curriculum training. The most common exams performed were 379 lung/pleural exams, 239 focused echocardiography and hemodynamic exams, and 237 abdominal exams. New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720). Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435). Conclusions. Implementation of POC ultrasound in the ICU with a structured fellowship curriculum was associated with an increase in new diagnosis in about 2/3 and change in management in over 1/3 of ICU patients studied.

No MeSH data available.


Related in: MedlinePlus