Activity

Activity ID

10507

Expires

May 11, 2024

Format Type

Live

CME Credit

22.5

Fee

$199 for Wednesday, $900 for Thursday, $900 for Friday, $650 for Saturday

CME Provider: Cleveland Clinic

Description of CME Course

The use of ultrasound-guided techniques to diagnose and treat various conditions is growing rapidly, fueled by data showing that ultrasound can improve the success rate of various treatments while decreasing complications.

Despite its potential for improving outcomes, ultrasound is not being used to its full potential, primarily owing to knowledge gaps regarding the available techniques and devices, indications, and expected outcomes for their use. Furthermore, ultrasound-guided techniques require substantial experience to be performed appropriately; however, many practitioners have not received adequate instruction or training on techniques. As a result, knowledge and competency gaps exist regarding how to best use ultrasound techniques.

Evaluation surveys. These educational gaps are supported by CME evaluations from attendees at ultrasound symposiums presented by the Cleveland Clinic. In those evaluations, the attendees, who are primarily physicians, indicated that three of the most pressing needs for educational activities are for presentations on techniques, patient selection, and therapeutic use. Informational data included in the educational needs were analyses of current data, updates on clinical practice implications, and reviews of published evidence. Their selection of topics indicate the existence of knowledge gaps in those areas.

Professional judgment. Supporting evidence for this educational need also comes from the Activity Directors, who have established that educational gaps exist between ultrasound techniques observed in clinical practice and those that are potentially achievable based on the current evidence. The Activity Directors cited their top sources as evidence from practice guideline revisions, evaluations from previous courses, and data from published articles as well as their professional observations. Their selection of topics indicates that knowledge gaps exist in these areas:
• Building a successful point-of-care ultrasound program
• Billing and coding for various ultrasound exams
• Basics science and techniques of ultrasound imaging
• Basics of echocardiography
• Focused assessment with sonography for trauma (FAST) examination
• Lung ultrasound
• Ultrasound for deep venous thrombosis and aortic pathologies
• Protocols, evaluation, and best use of echocardiography in critically ill patients
• Ultrasound guidance for needle placement and peripheral arterial and central venous access
• Role of ultrasound in paracentesis, thoracentesis, and soft tissue
• Rapid Assessment of Hemodynamically unstable patients using ultrasound

Published articles. Investigators continue to publish a large volume of articles on ultrasound technologies, providing in-depth assessment of advances, new devices and techniques, and implications for clinical practice. A Medline search for articles published in the most recent 5 years found more than 30,000 reviews and clinical trials. The pace and scope of these publications challenge health care practitioners to stay abreast of the data. In turn, this creates both knowledge and practice gaps among many practitioners who have neither the time nor the expertise to analyze the data and interpret their implications for clinical practice, which points to a need for educational activities presented by experts who review the techniques and demonstrate their best clinical use.

Educational need
These factors combine to create a need for an educational activity that presents a review of the current state-of-the-art ultrasound devices, indications for ultrasound, and provides hands-on instruction of ultrasound-guided techniques. Through a knowledgeable and skill-based approach to these practices, providers will be able to incorporate the most recent data into their clinical practice and, thus, optimize patient outcomes.

The Cleveland Clinic Center for Continuing Education strives to help physicians transfer acquired knowledge directly into their clinical practice as a method to improve patient outcomes. To help achieve that goal, the Center proposes an educational strategy that incorporates hands-on practice under the guidance of experts, a strategy that has been shown to successfully help the learner assimilate new techniques for making clinical practice changes that have a positive effect on patient care.

Faculty from large care centers with extensive experience using ultrasound-guided procedures to manage patients are in demand for their expertise. The Cleveland Clinic is a recognized leader in ultrasound techniques, and faculty members are qualified to provide an educational activity on ultrasound, as evidenced by learning objectives met, attendee numbers, and other quality measures at previous ultrasound presentations and workshops.

Summary
These factors combine to create a clear need for an educational activity that presents the current state-of-the-art techniques and hands-on workshops for ultrasound techniques and procedures. Through a knowledgeable approach to use of ultrasound, providers will be able to incorporate the most up-to-date techniques into their clinical practice and, thus, optimize patient outcomes.

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ABMS Member Board Approvals by Type
More Information
Commercial Support?
No

NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

Educational Objectives

Wednesday - Building a Point-of-Care Ultrasound Program
• Describe the components of successful point- of-care ultrasound programs
• Summarize process for image acquisition, machine utilization, and IT configuration
• Describe the importance of a training, quality improvement, and credentialing
• List components of billing and coding for various ultrasound exams

Thursday – Diagnostic POCUS Day
• Summarize the basic science and diagnostic use of ultrasound imaging
• Describe the protocols, evaluation, and best use of echocardiography in critically ill patients
• Review the role of ultrasound in a focused assessment with sonography in trauma (FAST) exam to assess for free fluid in the abdomen or around the heart
• Summarize the basics of using ultrasound to assess lungs
• Describe the most effective diagnostic use of ultrasound to assess for vascular abnormalities including aortic pathology and deep venous thrombosis
• Practice the evaluation of shock and respiratory failure with integration of skills utilizing the Rapid Ultrasound for Shock and Hypotension (RUSH) exam in a simulated setting

Friday – Procedural POCUS Day
• Understand the fundamental principles, indications, and necessary equipment for ultrasound guided peripheral and central venous access
• Understand the fundamental principles indications, and necessary equipment for ultrasound guided paracentesis, thoracentesis, and soft tissue aspiration
• Demonstrate competence for patient preparation, positioning, and needle placement for each of the ultrasound guided procedures listed above
• Recognize complications and discuss aftercare related to each of the ultrasound guided procedures listed above

Saturday - Hands-on Simulation Workshops
“RUSH” into your Practice: Assessing Critically Ill Patients in Shock
• Identify the hemodynamically compromised patient
• Describe the 3 components of the Rapid Ultrasound for Shock and Hypotension (RUSH) exam: Pump; Tank, Pipes
• Utilize the Rapid Ultrasound for Shock and Hypotension (RUSH) exam protocol in Simulation cases
• Explain the ultrasound findings seen in the 4 types of distributive shock

Advanced Assessment of the Rapidly Decompensating Patient
• Describe how to perform VTI to assess cardiac output
• Perform challenge of passive leg raise to assess volume responsiveness
• Describe assessment of the IVC diameter and its interpretation during spontaneous breathing

Keywords

Ultrasound, POCUS, Hands-on

Competencies

Medical Knowledge, Practice-based Learning & Improvement

CME Credit Type

AMA PRA Category 1 Credit

Practice Setting

Academic Medicine, Inpatient

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