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Critical Care Research and Practice
Volume 2014, Article ID 934796, 6 pages
http://dx.doi.org/10.1155/2014/934796
Research Article

Model Point-of-Care Ultrasound Curriculum in an Intensive Care Unit Fellowship Program and Its Impact on Patient Management

1Department of Surgery/Division of Trauma and Critical Care, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA
2Department of Pulmonary and Critical Care, Henry Ford Hospital, Detroit, MI 48202, USA
3Cleveland Clinic, Cleveland, OH 44195, USA
4Beaumont Hospital, Royal Oaks, MI 48073, USA
5Doctors Medical Center, Modesto, CA 95350, USA
6Wayne State University, Detroit, MI 48202, USA

Received 10 August 2014; Revised 2 October 2014; Accepted 30 October 2014; Published 16 November 2014

Academic Editor: Roland M. Schein

Copyright © 2014 Keith Killu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. This study was designed to assess the clinical applicability of a Point-of-Care (POC) ultrasound curriculum into an intensive care unit (ICU) fellowship program and its impact on patient care. Methods. A POC ultrasound curriculum for the surgical ICU (SICU) fellowship was designed and implemented in an urban, academic tertiary care center. It included 30 hours of didactics and hands-on training on models. Minimum requirement for each ICU fellow was to perform 25–50 exams on respective systems or organs for a total not less than 125 studies on ICU. The ICU fellows implemented the POC ultrasound curriculum into their daily practice in managing ICU patients, under supervision from ICU staff physicians, who were instructors in POC ultrasound. Impact on patient care including finding a new diagnosis or change in patient management was reviewed over a period of one academic year. Results. 873 POC ultrasound studies in 203 patients admitted to the surgical ICU were reviewed for analysis. All studies included were done through the POC ultrasound curriculum training. The most common exams performed were 379 lung/pleural exams, 239 focused echocardiography and hemodynamic exams, and 237 abdominal exams. New diagnosis was found in 65.52% of cases (95% CI 0.590, 0.720). Changes in patient management were found in 36.95% of cases (95% CI 0.303, 0.435). Conclusions. Implementation of POC ultrasound in the ICU with a structured fellowship curriculum was associated with an increase in new diagnosis in about 2/3 and change in management in over 1/3 of ICU patients studied.