scholarly journals Canadian Internal Medicine Ultrasound (CIMUS) Recommendations Regarding Internal Medicine Point-of-Care Ultrasound (POCUS) use during Coronavirus (COVID-19) Pandemic

2020 ◽  
Vol 15 (2) ◽  
pp. 8-11 ◽  
Author(s):  
Irene WY Ma ◽  
Ranjani Somayaji ◽  
Elissa Rennert-May ◽  
Joseph Minardi ◽  
Michael H Walsh ◽  
...  

With the COVID-19 pandemic, we are in unprecedented times - our clinical environment is changing rapidly and may continue to do so in the future. Over the last decade there has been an increased support for the use of internal medicine point-of-care ultrasound (POCUS) across the country and worldwide. While standard infection control guidelines are available on device and tranducer cleaning and disinfection, these recommendations may not apply during the COVID-19 pandemic. While we anticipate that the experience and need for POCUS deployment will differ across the country depending on several contextual factors, similar principles will likely emerge across multiple settings. To that end, to enable POCUS readiness, we recommend that each program/ practice site consider undertaking the following steps and recommendations on a semi-urgent basis if POCUS use is anticipated. The objective of this article to provide internists who currently use POCUS with the interim recommendations on processes that need to be in place prior to its use. This document refers primarily to the non-critical use of ultrasound devices based on the Spaulding classification6 (see Appendix for definitions) and does not apply to the setting of critical use where sterilization is required, nor semi-critical use, where high-level disinfection is required. Each institution must have its own policy in place on the cleaning and disinfection procedures for POCUS. This doucument is meant to serve as an adjunct to existing protocols.

2018 ◽  
Vol 38 (8) ◽  
pp. 2209-2215 ◽  
Author(s):  
Cameron M. Baston ◽  
Paul Wallace ◽  
Wilma Chan ◽  
Anthony J. Dean ◽  
Nova Panebianco

2018 ◽  
Vol 40 (11) ◽  
pp. 1130-1135 ◽  
Author(s):  
Daniel J. Schnobrich ◽  
Benji K. Mathews ◽  
Bernard E. Trappey ◽  
Brian K. Muthyala ◽  
Andrew P. J. Olson

2020 ◽  
Vol 19 (1) ◽  
pp. 57-57
Author(s):  
Ben Chadwick ◽  
◽  
Nick Murch ◽  
Anika Wijewardane ◽  
◽  
...  

Editor- Thank you for giving us the opportunity to respond to the letter received regarding the Joint Royal College of Physicians Training Board (JRCPTB) curriculum for Acute Internal Medicine (AIM) that has previously been circulated for comment and consideration of implementation in August 2022. Dr Williamson is correct in asserting that the proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It does aim to produce a workforce that reflects the current trends of increasing patient attendances to both primary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with co-morbidities and recognise when specialty input is required in a variety of settings, including ambulatory and critical care. Contrary to the situation described in the correspondence, the new curriculum does not move away from each trainee being required to develop a specialist skill, such as medical education, management, stroke medicine or focused echocardiography. Trainees will still need to acquire competency in a specialist skill for their final 36 months of their training programme, usually after they have completed their Point of Care Ultrasound (POCUS) certification. The thinking behind introducing mandatory POCUS in the curriculum is that: POCUS is in the proposed curricula for intensive care medicine, respiratory medicine and emergency medicine, therefore we feel that in order to recruit the best trainees it is imperative POCUS training is offered as standard As evidenced by the trainee surveys, they often do not get allocated time to develop their specialist skill, especially in the early years of Higher Specialty Training before they often have decided on a particular skill. The introduction of mandatory POCUS training should legtimise time off the ward to obtain this skill early in training. POCUS is becoming more and more standardised in 21st Century acute care alongside the reducing costs of Ultrasound probe e.g. Philips Lumify and Butterfly iQ which are compatible with smart phones POCUS has been heralded as the fifth pillar of examination (observation, palpation, percussion, auscultation, insonation)1 The proposed curriculum therefore facilitates trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This will also enable trainees to have time away from the ‘front door’ high intensity acute care. Mandatory POCUS will continue to set AIM training apart from other physician training programmes and continue to attract high quality trainees to apply to the specialty. Formal feedback seen at the SAC meeting in October 2019 to the draft curriculum (personal correspondence from JRCPTB) showed a positive response from nine individuals, an ambivalent one from two people, and only two against the introduction of formal POCUS training in the curriculum. Point of Care Ultrasound will likely be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country. Concerns regarding supervision are being addressed by the POCUS working group, in anticipation of the lead in period of well over two years. It is anticipated that most trainees can achieve POCUS sign off (e.g. Focused Acute Medical Ultrasound) in 6 to 12 months (personal correspondence Nick Smallwood from POCUS working group). With ongoing concerns regarding recruitment and retention in Acute Internal Medicine we agree strongly that with POCUS inclusion, we have a further selling point for AIM training.


2016 ◽  
Vol 3 ◽  
pp. JMECD.S18932 ◽  
Author(s):  
Melissa Nardi ◽  
David J. Shaw ◽  
Stanley A. Amundson ◽  
James N. Phan ◽  
Bruce J. Kimura

Over the past two decades, our internal medicine residency has created a unique postgraduate education in internal medicine by incorporating a formal curriculum in point-of-care cardiac ultrasound as a mandatory component. The details regarding content and implementation were critical to the initial and subsequent success of this novel program. In this paper, we discuss the evidence-based advances, considerations, and pitfalls that we have encountered in the program's development through the discussion of four unanticipated tasks unique to a point-of-care ultrasound curriculum. The formatted discussion of these tasks will hopefully assist development of ultrasound programs at other institutions.


2018 ◽  
Vol 111 (7) ◽  
pp. 439-443 ◽  
Author(s):  
Irene W. Y. Ma ◽  
Chiara Cogliati ◽  
Frank H. Bosch ◽  
Ana Claudia Tonelli de Oliveira ◽  
Vincenzo Arienti ◽  
...  

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