SURG 5000

Surgery Clerkship - Ultrasound

INTRODUCTION

The Surgery Clerkship Ultrasound requirements aim to provide clinically relevant education on how to use point-of-care ultrasound (POCUS) during your Surgery clerkship. The ultrasound requirements are designed to give you a deeper understanding of some of the concepts taught during the clerkship through the experience of ultrasound.

Ultrasound at the bedside to document the presence of free fluid in the abdomen, chest, and pelvis along with imaging of the gallbladder is performed on the majority of patients that are seen in the trauma or other surgical setting. Since these aspects of the FAST exam and gallbladder are so frequently performed, we want our medical students to be proficient at this exam as they move through this clerkship.

QUICK LINKS:

MCG C/O 2027 Clerkship Ultrasound Orientation  Email Ultrasound Image Link FAQ

Educational Ultrasound Informed Patient Consent  SURG US Image and Case Info Upload Link

HOW TO DOWNLOAD IMAGES FROM MACHINES OTHER THAN LUMIFY 

Philips Sparq    Sonosite    GE   Cart-Based Ultrasound

LEARNING OBJECTIVES

At the end of this module, you will be able to:

  • Acquire FAST with gallbladder ultrasound images with limited assistance.
  • Interpret the findings of the FAST with gallbladder ultrasound images on actual patients and mock case scenarios. 
  • Integrate the findings of the FAST and gallbladder ultrasound images in the care plan of actual patients and mock case scenarios.

Intro to FAST Exam

TO DO

Complete the following quizzes (includes patient consent attestation, image upload, and mock case scenario questions) prior to the end of your Surgery clerkship rotation by submitting 3 separate quizzes in this D2L course by the noted due dates.

Quiz 1    Quiz 2    Quiz 3

You will receive feedback on your images by email after they are graded. Quizzes must be completed by due dates.

WHAT DOES THE SURGERY CLERKSHIP ULTRASOUND IMAGE REQUIREMENT INCLUDE?

The Surgery Clerkship Ultrasound requirement consists of documentation of the presence or absence of free fluid in the chest, abdomen, and pelvis (FAST Scan) as well as a gallbladder image.  

  • The right upper quadrant view includes the right lobe of the liver with the right hemi-diaphragm, right kidney, and the hepatorenal space (Morrison's pouch).
  • The subcostal (subxyphoid) 4-chamber heart view includes the left lobe of the liver and visualization of the 4 chambers of the heart.
  • The left upper quadrant view includes the spleen with the left hemi-diaphragm and left kidney.
  • The pelvis view includes the urinary bladder and either the prostate or uterus.

Alternatively - You may complete one or all of your ultrasound image requirements in the operating room under direct faculty supervision. Saving images is not required in this setting. You will complete the same submission survey and attest to imaging performed in the operating room and indicate the email address of the faculty member who directly supervised your image acquisition.

WHAT SHOULD THE IMAGES FOR THE SURGERY CLERKSHIP ULTRASOUND REQUIREMENT LOOK LIKE?

ruq

Right Upper Quadrant

subcostal

Subcostal 4-Chamber Heart

gb

Gallbladder

luq

Left Upper Quadrant

pelvis

Pelvis

 

DO I NEED TO DOCUMENT INFORMED CONSENT FOR THE PATIENT BEFORE I BEGIN THE EDUCATIONAL ULTRASOUND?

Yes, you will need to ask your preceptor and the patient if you can perform an educational ultrasound for your Surgery Clerkship Ultrasound requirement. Once the patient has agreed to be scanned, you will need to explain the procedure to them and include the following aspects:

  • Ultrasound has no known adverse side effects and it uses sound waves to visualize structures
  • The patient will not be charged for the educational ultrasound (They may have an additional ultrasound for clinical reasons for which they will be charged)
  • The student will touch their abdominal wall and pelvis with the transducer on their body with possibly cold gel and cool, gloved hands to obtain the images
  • The lights in the room may be dimmed for better visualization of the images
  • Results from the educational ultrasound will not be included in their chart or patient care decisions
  • If any type of problem is detected, the student will inform their preceptor and the preceptor will direct the next steps 

After reviewing this information with the patient, the student will ask the patient to type their name and sign the Educational Ultrasound Informed Patient Consent. Images will NOT be accepted for the requirement if the patient does not complete this consent.

WHAT DOES THE SURGERY CLERKSHIP ULTRASOUND REQUIREMENT QUIZ INCLUDE?

The Surgery Clerkship Ultrasound Requirement Quiz includes:

  • Attestation question that you and your patient completed an "Educational Ultrasound Informed Patient Consent" prior to scanning your patient
  • Attestation question that you have submitted your images and case information through the provided link
  • Acquiring three sets of images for submission on three different patients
  • Surgery ultrasound content and case questions

WHAT IF I HAVE TROUBLE OBTAINING PATIENTS FOR IMAGING, IDENTIFYING EQUIPMENT TO USE, OR HAVE TROUBLE UPLOADING IMAGES?

Contact Katie Comeaux at kcomeaux@augusta.edu or call 706-721-5695

ADDITIONAL RESOURCES:         

CUSE YOUTUBE CHANNEL   Clinical US ebook   Clinical US ibook download  Interactive cases  Making Healthcare Safer