Introduction The American Board of Emergency Medicine recently established a new certification pathway in advanced emergency medicine ultrasound (AEMUS). Eligible applicants come from a wide range of experience but must pass the same examination to become certified. This study sought to evaluate a novel review course targeting a wide range of learners for a new examination. Methods This was a cross‐sectional study evaluating the outcomes of the American College of Emergency Physicians (ACEP) AEMUS review course. The program evaluation survey was designed to collect outcomes across multiple Kirkpatrick levels, including overall satisfaction, topic‐specific satisfaction, topic‐specific coverage, topic‐specific confidence before and after the course, topic‐specific perceived knowledge before and after the course, and changes in practice. Results Seventy‐four of 79 participants (93.7%) completed the survey. Mean course satisfaction was 4.59/5.00 (95% CI 4.47–4.72). Confidence to pass examination components increased for the following topics: administration, advanced left ventricle (LV), education, head and neck, hepatobiliary, male genitourinary, musculoskeletal, nonobstetric gynecology, pediatrics, physics, procedures, research, right ventricle, and venous/arterial. Perceived knowledge increased for the following topics: administration, advanced LV, education, head and neck, male genitourinary, musculoskeletal, pediatrics, physics, procedures, renal/bladder, research, right ventricle, and venous/arterial. Fifty‐three of 74 participants (71.6%) stated they would change their practice based on the course. Examples of changes in practice include increased use of ultrasound for advanced abdominal, musculoskeletal, pediatric, and procedural applications. Future work will determine the impact on longer‐term outcomes and focused practice designation (FPD) examination pass rates. Conclusion The ACEP AEMUS FPD review course demonstrated high levels of satisfaction, increased participant confidence, increased perceived knowledge, and several self‐reported changes in participants' ultrasound practice.
Background Patients with COVID-19 present with diagnostic challenges as it can cause varied end-organ failures that mimic respiratory distress of pulmonary origin. Early identification of concurrent complications can significantly alter patient management and course. Point-of-care ultrasound (POCUS) can be particularly useful in helping to differentiate concomitant complications with COVID-19. While lung POCUS findings related to COVID-19 have been published, little guidance exists on how ultrasound can be incorporated into a more comprehensive evaluation of patients under investigation (PUI) for COVID-19. Objectives We devised a pathway called COVUS that incorporates POCUS into the initial evaluation of PUIs for COVID-19 to guide diagnosis and management. Discussion The pathway was derived based on review of literature, consensus from the ultrasound faculty, as well as feedback from the entire faculty group at one academic institution with high volumes of COVID-19 patients. The scanning protocol utilizes a cardiac first, rather than lung first, approach to identify potential concomitant organ failure that may immediately alter management. Conclusions COVUS aims to maximize identification of the most immediately life-threatening complications while minimizing time at bedside and provider risk of exposure to COVID-19.
Right ventricular (RV) dilation has been observed in patients in cardiac arrest. Historically, this phenomenon is almost always attributed to massive pulmonary embolism. However, recent advancements have revealed that there are many other causes of RV dilation in cardiac arrest. In this case report, we present the case of an elderly woman who was found in cardiac arrest with an initial normal left ventricle to RV ratio with subsequent development of RV dilation in the midst of resuscitation without changes to other hemodynamic parameters. This case further bolsters the complex nature of cardiac physiology in cardiac arrest and the need for further investigation.
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