Anesthesia — Core of Discipline

C6 Demonstrating required skills in POCUS (point of care ultrasound) to answer a clinical question.

- The focus of this EPA is the use of POCUS as a patient assessment tool, with observation of both normal POCUS exams and POCUS exams completed with the purpose of answering a clinical question.
- This EPA includes obtaining standard ultrasound views in POCUS including: cardiac – parasternal long-axis and short-axis; apical 4-chamber; subcostal 4-chamber subcostal inferior vena cava; pulmonary.
- This EPA may include both transthoracic or transesophageal techniques for cardiac ultrasound images.

Form

F1: Observation

Milestones

• COM 1.2. Optimize the physical environment for patient comfort, privacy, engagement, and safety

• ME 3.2. Use shared decision-making in the consent process, taking risk and uncertainty into consideration

• ME 1.3. Apply clinical and theoretical knowledge of echography to anesthesiology and critical care practice

• ME 3.4. Adjust echocardiographic instrument settings appropriately to optimize image quality

• ME 3.4. Acquire images of focused transthoracic echocardiography exam and pulmonary echographic exam

• ME 2.2. Interpret focused transthoracic echocardiography exam for common pathologies including hypovolemia, left and right ventricular failure and pericardial effusion and tamponade

• ME 3.1. Integrate all sources of information to develop a management plan that is safe, patient-centred, and considers the risks and benefits of all approaches

• ME 3.4. Document procedures accurately

• ME 4.1. Determine the need and timing of consultation with other specialists

• COL 2.1. Actively listen and respond to patient cues

• COM 5.1. Document clinical encounters to adequately convey clinical reasoning and the rationale for decisions

Context Variables

No context variables defined.

Requirements

• Direct observation or review of images by supervisor
• Use Form 1 or local alternative. Form collects information on:
• Type of exam: cardiac; pulmonary; cardiopulmonary; other exam
• Technique: transthoracic; transesophageal
• Location: preoperative; intraoperative; ICU; emergency room
• Purpose of the exam: normal standard views; answering a clinical question
• Clinical situation: stable patient; unstable patient
• Collect observations from a large breadth of situations including different types of exams with the expectation not all will be achieved, with a minimum of
• 3 direct observations obtaining transthoracic cardiac standard views
• 3 direct observations applying ultrasound data to answer a clinical question