title: Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management.
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.
authors.affiliation: Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Killu
authors.affiliation: Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Coba
authors.affiliation: Department of Pulmonary and Critical Care, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mendez
authors.affiliation: Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Subhash
authors.initials: S
authors.lastname: Reddy
authors.affiliation: Beaumont Hospital, Royal Oaks, MI 48073, USA.
authors.forename: Tanja
authors.initials: T
authors.lastname: Adrzejewski
authors.affiliation: Doctors Medical Center, Modesto, CA 95350, USA.
authors.forename: Yung
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Wayne State University, Detroit, MI 48202, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ede
authors.affiliation: Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
authors.forename: Mathilda
authors.initials: M
authors.lastname: Horst