uspcc bl1 provider ultrasound pediatric critical care · 8,45-9,15 tecnica ecografica, punti di...
TRANSCRIPT
UUSSPPCCCC BBLL11 ~~ PPRROOVVIIDDEERR
UULLTTRRAASSOOUUNNDD
PPEEDDIIAATTRRIICC CCRRIITTIICCAALL CCAARREE 'USCMC LEVEL 1’ CERTIFICATION SKILL SET
ENTRY COURSE FOR ‘USPCC BL1-P’ [ULTRASOUND PEDIATRIC CRITICAL CARE - BASIC LEVEL 1 - PROVIDER]
VVeerroonnaa,, 2288--2299 NNoovveemmbbrree 22001122
HHootteell SSaann MMaarrccoo VViiaa LLoonngghheennaa,, 4422 -- VVeerroonnaa
www.winfocus.org
CCOOUURRSSEE DDIIRREECCTTOORR
Stefano Marzini, Verona
CCOOUURRSSEE CCOO--DDIIRREECCTTOORR
Enrico Storti, Milano
CCOOUURRSSEE FFAACCUULLTTYY
Amedeo Bianchini, Bologna
Stefano Marzini, Verona
Francesca Melosi, Pistoia
Pierantonio Santuz, Verona
Luca Tortorolo, Roma
TTRRAAIINNEERR OONN TTRRAAIINNIINNGG
Maria Elena Latrofa, Bologna
WWIINNFFOOCCUUSS CCOONNTTAACCTTSS
Secretariat Office
Via Orefici, 4 - 40124 Bologna, ITALY
Tel +39 051 230385
Fax +39 051 221894
www.noemacongressi.it
www.noemacongressi.it/english.html
Executive Office – Board
Via Borgonuovo, 4 - 20124 Milano, ITALY
Tel +39 333 5404074
Fax +39 02 700531930
www.winfocus.org
““ CCRRIITTIICCAALL UULLTTRRAASSOOUUNNDD””
The concept of 'critical ultrasound' evolved recently from 'emergency ultrasound' performed at the 'point-of-care' in scenarios such as emergency departments, ICUs, pre-hospital care, austere environments, disaster scenes, tactical operations, and humanitarian care missions. Clinical scenarios turn into 'critical' ones when there is a dangerous performance gap between the patient status and the resources available for an appropriate decision making and problem solving. In such settings ultrasound point-of-care image acquisition and interpretation, integrated with advanced life support protocols (ACLS, ATLS) according 'ABCDE' and 'Head-to-toes' -type approaches, allows for rapid and effective decision making, enhanced triage, diagnosis, therapy, monitoring, and follow up. Nowadays, that’s approach is also known as ‘Ultrasound Life Support’. This typically occurs in the acutely ill patient (Emergency US) or intensive (Intensive/Critical Care US), and/or where human or technical resources are particularly limited (Screening US, Triage US, Remote US, Primary US).
WWIINNFFOOCCUUSS ((WWoorrlldd IInntteerraacctt iivvee NNeettwwoorrkk FFooccuusseedd OOnn CCrrii tt iiccaall UUll tt rraaSSoouunndd)) The world leader scientific organization committed to develop point-of-care ultrasound
practice, research, education, technology, and networking, addressing the needs of patients, institutions, services, and communities in “critical” scenarios.
WWIINNFFOOCCUUSS VViissiioonn aanndd MMiissssiioonn SSttaatteemmeennttss Improving Primary, Emergency, and Critical Care Medicine, by incorporating "point-of-care" Ultrasound into Clinical Practice … bringing quality “Point-of-care” Ultrasound to the patient
in all out-of-hospital and in-hospital “critical” scenarios, by developing and fostering, on a global and multi-disciplinary basis, Ultrasound Education, Technological Development,
Evidence-based Research, and International Teamwork.
MERCOLEDì 28 NOVEMBRE 2012
INIZIO CORSO
8,00-8,30 Registrazione
8,30-8,50 Winfocus, US Point-of-Care e Focused US. Obiettivi del Corso
Stefano Marzini, Verona
8,50-9,00 Test pre-Corso
INTRODUZIONE ALLA ECOGRAFIA
9,00-9,20 Brevi cenni su: fisica del suono, acquisizione immagini e interpretazione, gestione principali comandi
Luca Tortorolo, Roma
AIRWAY - Valutazione
9,20-9,40 Tecnica ecografica, punti di repere, valutazione VVAA, assistenza e verifica intubazione, verifica
sondino gastrico, riempimento gastrico
Stefano Marzini, Verona
BREATHING - Valutazione
9,40-10,10 Tecnica ecografica, punti di repere, polmoni normali, principali quadri patologici acuti
(versamento pleurico, pnx, contusione polmonare, polmonite, sindrome interstiziale, atelectasie)
Stefano Marzini, Verona
BREATHING - Valutazione
10,10-10,40 Tecnica ecografica, punti di repere, patologie della pleura, versamento pleurico, pnx, diaframma,
patologie croniche
Pierantonio Santuz, Verona
CIRCULATION - Valutazione / CUORE
10,40-11,10 Tecnica ecografica, punti di repere, cuore normale, principali quadri patologici
(dilatazioni, ipertrofie, versamento pericardico, segni di ipertensione polmonare, miocardiopatie)
Stefano Marzini, Verona
11,10-11,30 BREAK
US HOT - 1 Esercitazioni su Airway, Breathing, Circulation-c
11,30-13,00 N. 3 stazioni da 30’ cad.
A: Stefano Marzini, Verona - B: Francesca Melosi, Pistoia - C: Pierantonio Santuz, Verona
13,00-14,00 LUNCH BREAK
CIRCULATION - Valutazione / VASI-CIRCOLO
14,00-14,30 Tecnica ecografica, punti di repere, visualizzazione vene periferiche e centrali, VCI-VGI,
valutazione emodinamica ecografica
Amedeo Bianchini, Bologna
DISABILITY - Valutazione
14,30-15,00 Tecnica ecografica, ecografia trans-bulbare, ecografia trans fontanellare (cenni), eco cranio
Francesca Melosi, Pistoia
EXPOSURE - Valutazione
15,00-15,30 EFAST, versamento addominale, vescica, ecografia integrata, lesioni maggiori ARTI
Luca Tortorolo, Roma
15,30-16,00 BREAK
US HOT - 2 Esercitazioni su Circulation-v, Disability, Exposure, Phantom accesso vascolare
16,00-18,30 N. 4 stazioni da 40’ cad. con due rotazioni
Amedeo Bianchini, Bologna - Francesca Melosi, Pistoia - Luca Tortorolo, Roma
Maria Elena Latrofa, Bologna
18,30-18,45 DOMANDE E COMMENTI
GIOVEDì 29 NOVEMBRE 2012
INIZIO CORSO
8,30-8,45 Presentazione della giornata e informazioni generali
Stefano Marzini, Verona
A-B-C-D Procedure eco-assistite\eco-guidate
8,45-9,15 Tecnica ecografica, punti di repere, A: cricotomia d’urgenza - B: toracentesi, drenaggio PNX,
reclutamento polmonare ecoassistito - C: IO, CVC, CPR - D: rachicentesi
A: Stefano Marzini, Verona – B: Pierantonio Santuz, Verona
C: Francesca Melosi, Pistoia – D: Luca Tortorolo, Roma
CASI CLINICI Visualizzazione di clips, analisi della tecnica ecografica e diagnosi POC
da parte dei discenti
10,15-11,30 Discussione interattiva
Amedeo Bianchini, Bologna - Francesca Melosi, Pistoia - Pierantonio Santuz, Verona
Luca Tortorolo, Roma - Maria Elena Latrofa, Bologna
11,30-11,50 BREAK
US ABCDE. Primary management. Discussione interattiva
11,50-12,10 Gestione integrata. Arresto intraospedaliero
Luca Tortorolo, Roma
12,10-12,30 Gestione integrata. Insufficienza respiratoria acuta - dispnea
Pierantonio Santuz, Verona
12,30-12,50 Gestione integrata dello shock
Amedeo Bianchini, Bologna - Stefano Marzini, Verona
15,50-13,10 Gestione integrata del trauma severo
Francesca Melosi, Pistoia
13,10-14,00 LUNCH Break
US HOT - 3 Esercitazioni su CPR, shock, trauma, dispnea
14,00-16,00 N. 3 stazioni da 45 cad.
Francesca Melosi, Pistoia - Amedeo Bianchini, Bologna
Luca Tortorolo, Roma - Pierantonio Santuz, Verona
16,00-16,30 BREAK
US ABCDE Secondary management
16,30-17,00 Management e monitoring (concetti base)
Stefano Marzini, Verona
CHIUSURA DEL CORSO
17,00-17,15 Sottolineatura dei messaggi più importanti
Maria Elena Latrofa, Bologna
17,15-17,45 Questionario di valutazione e apprendimento
17,45-18,00 Questionario di gradimento del corso (ECM) e valutazione interna
Amedeo Bianchini, Bologna
18,00-18,15 Note su certificazione, provider e istruttore, centri di formazione WF
Stefano Marzini, Verona
18,15-18,30 CONCLUSIONE E CONSEGNA ATTESTATI DI PARTECIPAZIONE
UUSSCCMMEE GGLLOOBBAALL PPRROOGGRRAAMM DDIIRREECCTTOORRSS::
Chair: Luca Neri (Milan, Italy) Co-chairs : Richard Hoppmann (Columbia, SC, USA), Enrico Storti (Milan, Italy) Advisors: Michael Blaivas (Atlanta, GA, USA): Winfocus President, RESCUE & ILCEUS Chair
Daniel Lichtenstein (Paris, France): Winfocus Scientific Comm. Chair
UUSSCCMMCC LLEEAARRNNIINNGG CCOONNTTEENNTTSS aanndd FFOORRMMAATT ::
The applications targeted in the USCMC (www.winfocus.org/uscme/uscmc ~ Ultrasound Critical Management Certification) program rely on the most recent literature and recommendations, and refer mostly to the “Critical Care Medicine Journal” Supplement fully dedicated to the ultrasound applications in the acute and critical patients (Crit Care Med 2007;35[Suppl]), written by a few dozens of the actual major world experts in the field, coordinated by Blaivas, Kirkpatrick and Sustic, and mostly involved in the Board of WINFOCUS. Proposed educational formats and pathways refer to a working document, published in its earliest version in the same supplement (Neri L, Storti E, Lichtenstein D, Toward an ultrasound curriculum in critical care medicine. Crit Care Med 2007;35[Suppl]:S290–S304), starting point of an International evidence- and consensus-based process, join to the USCME and ILCEUS projects (www.winfocus.org/rescue/ilceus).
UUSSCCMMCC EEDDUUCCAATTIIOONNAALL CCEERRTTIIFFIICCAATTIIOONN RROOAADDMMAAPP ::
Certification steps are implemented along the three EFSUMB levels of proficiency (www.efsumb.org):
• Level 1 (BL1 & AL1, Basic and Advanced) - Common, general, focused competency
• Level 2 (BL2 & AL2, Basic and Advanced) - Comprehensive, specialized competency
• Level 3 (beyond standards, still to be defined) - Outstanding clinical, educational, research expertise
Each level includes Provider and Trainer competence-based modules (see below as ex. the USLS roadmap):
“ULTRASOUND LIFE SUPPORT” competence-based certification pathways:
• USLS BL1 Provider >> Trainer (“ABCDE” conformed, non-specialty-specific, general)
• USLS AL1 Provider >> Trainer (“Head-to-Toes” conformed, setting/specialty-specific, general)
• USLS BL2 Provider >> Trainer (Problem-based, setting/specialty-specific, specialized)
• USLS AL2 Provider >> Trainer (Organ/District-based, setting/specialty-specific, sub-specialized)
Ex. ECHO-AL2 Provider >> Trainer (Advanced “Echo-Doppler in ICU” competences)
According specific performance needs, several Level 1 and 2 (L1, L2) UltraSound Life Support and Procedural modules are available, both for Providers and Trainers (P, T):
• US-TLS (US Trauma Life Support, ATLS-conformed) • EFAST (Extended Focused Assessment with Sonography for Trauma)
• US-ACLS (US Cardio-Pulmonary Life Support, ACLS/ALS-conformed) • US-BLSD (US Cardio-Pulmonary Life Support, BLS/LSD-conformed)
• US-NPLS (US Neonatal & Pediatric Life Support, PALS-conformed) • US-PHLS (US PreHospital Care & Disaster Medicine Triage)
• US-Triage (US Triage in Disaster Medicine)
• CC ECHO (Critical Care Echocardiography or ECHO ICU) • US-MON (US ABCDE Monitoring) • US-SEPS (US Sepsis Management)
• US-GPE (US General Practice in Emergency) • US-PHC (US Primary Health Care in scarce-resource-setting) • US-NURSE (US Nursing care in Emergency)
• US-AIR (US Airway Management) • US-CVA (US Central Vascular Access Management) • US-PVA (US Peripheral Vascular Access Management) • US-BLOCK (US-guided Nerve Blockage)
Note: USLS BL1 Certification includes US-TLS, US-PHLS, EFAST, US-BLS, US-ACLS credentialing.
Each certification module is developed along three learning phases and a final examination:
• Part Ia: preliminary e-learning (lectures, interactive sessions, references)
• Part Ib: 1-2 days introductory course (theory, hands on, and simulation components)
• Part II: 1-6 months proctored practice (specific minimal requirements)
• Part III: 1 day credentialing examination (presentation, questionnaire, simulation-based practice)
Each credential profile undergoes maintenance and quality assurance processes:
• Refresh: 1-2 day course (every 2 years; specific annual minimal requirements)
UUSSCCMMEE AAUUDDIIEENNCCEE TTAARRGGEETTSS ::
- Health care professionals: Physicians, Nurses, Paramedics, Midwives, and Technicians … working in
- “Critical” scenarios: EM, CCM/ICU, Acute/Trauma Surgery, HEMS/EMS, PHC, Pediatric, Sport, Tactical, Remote, Rural, Wilderness, Scarce-resource settings.
Further details at www.winfocus.org/uscme