Critical Care Ultrasound Course: Adult

7:00 a.m. – 7:30 a.m. | Breakfast

7:30 a.m. – 7:45 a.m. | Welcome & Introductions (Bob Gibson, ACNP) 

7:45 a.m. – 8:30 a.m. | Ultrasound Physics and Knobology (Dr. Dell Simmons)

• Explain the basics of ultrasound physics
• Explore the inverse relationship between resolution and depth in ultrasound imaging
• Identify the different modes of ultrasound imaging
• Discuss the ultrasound device platform
• Demonstrate basic image optimizing techniques

8:30 a.m. – 9:15 a.m. | Basic Windows and Views (Bob Gibson, ACNP) 

• Define critical care echocardiography
• Discuss the importance of basic windows
• Acquire optimal images
• Troubleshoot suboptimal images

9:15 a.m. – 9:30 a.m. | Break

9:30 a.m. – 11:30 a.m. | Skills Stations (Bob Gibson, ACNP & Dr. Nirosshan Thiruchelvam, MD)

• Apical Views
• Parasternal Views
• Subcoastal Views

11:30 a.m. – 12:15 p.m. | Lunch Cases (Bob Gibson, ACNP)

• Review a series of cases focused on the topics covered in this morning’s presentations
• Apply the knowledge gained from presentations when responding to questions posed in the cases
• Evaluate your knowledge of the topics covered in this afternoon’s presentations.

12:15 p.m. – 12:45 p.m. | Echocardiographic Evaluation: Right Ventricular (RV) Dysfunction (Dr. Nirosshan Thiruchelvam)

• Explore RV anatomy
• Discuss morphologic assessment of RV
• Perform functional assessment of RV

12:45 p.m. – 1:15 p.m. | Left Ventricular (LV) Function and Cardiac Output (Dr. Dell Simmons)

• Discuss global quantitative and qualitative measurements of LV systolic function (fractional shortening, mitral annular plane systolic excursion, E-point septal separation, 2D and 3D imaging)
• Perform Doppler assessment of cardiac output

1:15 p.m. – 1:45 p.m. | Echocardiographic Evaluation of Hypovolemia and Volume Responsiveness (Dr. Nirosshan Thiruchelvam)

• Evaluate and recognize hypovolemia
• Recognize predictors of volume responsiveness in spontaneously ventilated and passively mechanically ventilated patients
• Assess effectiveness of volume loading.

1:45 p.m. – 2:00 p.m. | Break

2:00 p.m. – 2:30 p.m. | Venous Excess Ultrasound (VExUS) (Dr. Nirosshan Thiruchelvam)

• Discuss volume responsiveness vs volume tolerance
• Identify VExUS scanning windows
• Apply imaging to assessment of volume status and congestion

2:30 p.m. – 2:45 p.m. | Break

2:45 p.m. – 5:00 p.m. | Skill Stations (Dr. Dell Simmons, Dr. Nirosshan Thiruchelvam & Bob Gibson, ACNP)

• Cardiac Output
• Volume Assessment
• Left/Right Ventricular Function

7:00 a.m. – 7:30 a.m. | Breakfast

7:30 a.m. – 7:45 a.m. | Pre-test Review

7:45 a.m. – 8:15 a.m. | Ultrasound and Pulmonary Embolism (Bob Gibson, ACNP)

• Discuss epidemiology
• Discuss the pathophysiology of PE
• Review the Wells criteria for CT angiography deferral
• Recognize non-ultrasound markers of PE
• Practice ultrasound assessment of PE
• Evaluate PE and associated RV dysfunction
• Practice lower extremity ultrasound evaluation of deep vein thrombosis (DVT)

8:15 a.m. – 8:45 a.m. | Pericardial Tamponade: Evaluation of Tamponade Physiology (Dr. Dell Simmons)

• Differentiate between acute versus chronic pathophysiology
• Review ventricular interdependence
• Discuss clinical diagnoses
• Describe reciprocal respiratory changes of Doppler velocity
• Recognize pitfalls

8:45 a.m. – 9:15 a.m. | Echocardiographic Approach to Shock (Bob Gibson, ACNP)

• Describe a system algorithm
• Apply quantitative and qualitative assessments
• Explain coronary blood flow and its relationship to shock
• Recognize patterns

9:15 a.m. – 9:45 a.m. | Abdominal Ultrasound: eFAST and Beyond (Todd Roland, PA-C)

• Review the principles of the eFAST examination
• Practice techniques for image acquisition
• Interpret ultrasound images
• Evaluate the clinical relevance of the eFAST examination
• Explore additional applications of abdominal ultrasound

9:45 a.m. – 10:00 a.m. | Break

10:00 a.m. – 12:00 p.m. | Skill Stations (Todd Roland, PA-C, Dr. Nirosshan Thiruchelvam & Bob Gibson, ACNP)

• FAST Examination
• Ultrasound Assisted PIV/Midline Insertion
• Focused Assessed Transthoracic Echocardiography (FATE) Examination

12:00 p.m. – 1:00 p.m. | Lunch Cases (Dr. Nirosshan Thiruchelvam & Todd Roland, PA-C)

• Review a series of cases focused on the topics covered in this morning’s presentations
• Apply the knowledge gained from presentations when responding to questions posed in the cases
• Evaluate your knowledge of the topics covered in this afternoon’s presentations

1:00 p.m. – 1:30 p.m. | Vascular Ultrasound: Deep Venous Thrombosis and Vascular Access (Dr. Nirosshan Thiruchelvam)

• Recognize DVT risk factors
• Practice ultrasound evaluation for DVT
• Practice ultrasound techniques for vascular access
• Identify troubleshooting pitfalls.

1:30 p.m. – 2:15 p.m. | Approach to Lung Ultrasonography (Dr. Dell Simmons)

• Discuss the anatomy of pleural space
• Practice ultrasound evaluation of pneumothorax, effusion, and consolidation
• Practice ultrasound approach to performing thoracentesis

2:15 p.m. – 2:30 p.m. | Break

2:30 p.m. – 5:00 p.m. | Skill Stations (Dr. Dell Simmons, Bob Gibson, ACNP & Dr. Nirosshan Thiruchelvam)

• Lung Ultrasound
• Thoracentesis
• Vascular Ultrasound
• Ultrasound Assisted Central Line Insertion
• Venous Excess Ultrasound (VExUS)

5:00 p.m. | Adjourn (Bob Gibson, ACNP)

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