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Critical Care Basic Ultrasound Learning Goals for American Anesthesiology Critical Care Trainees: Recommendations
R Eliot Fagley1, Michael F Haney, Anne-Sophie Beraud
1From the Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington; Umeå University Anesthesiology and Intensive Care Medicine, Umeå, Sweden; Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, California; Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; Department of Anesthesiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon; Department of Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Department of Anesthesiology and Critical Care, Vanderbilt University School of Medicine, Nashville, Tennessee; and Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Objective:
In this review, we define learning goals and recommend competencies concerning focused basic critical care ultrasound (CCUS) for critical care specialists in training.
Design:
The narrative review is, and the recommendations contained herein are, sponsored by the Society of Critical Care Anesthesiologists. Our recommendations are based on a structured literature review by an expert panel of anesthesiology intensivists and cardiologists with formal training in ultrasound. Published descriptions of learning and training routines from anesthesia-critical care and other specialties were identified and considered. Sections were written by groups with special expertise, with dissent included in the text.
Results:
Learning goals and objectives were identified for achieving competence in the use of CCUS at a specialist level (critical care fellowship training) for diagnosis and monitoring of vital organ dysfunction in the critical care environment. The ultrasound examination was divided into vascular, abdominal, thoracic, and cardiac components. For each component, learning goals and specific skills were presented. Suggestions for teaching and training methods were described.
Discussion:
Immediate bedside availability of ultrasound resources can dramatically improve the ability of critical care physicians to care for critically ill patients. Anesthesia--critical care medicine training should have definitive expectations and performance standards for basic CCUS interpretation by anesthesiology--critical care specialists. The learning goals in this review reflect current trends in the multispecialty critical care environment where ultrasound-based diagnostic strategies are already frequently applied. These competencies should be formally taught as part of an established anesthesiology-critical care medicine graduate medical education programs.
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