The use of ultrasound in medicine has greatly increased over the last several years and this technology has especially been embraced by emergency physicians as an efficient way to evaluate patients with a variety of clinical conditions.
Under the direction of the ultrasound director, Nick Hoda, MD, and assistant director/fellowship director Brian Tollefson, MD, this technology has been fully integrated into the day-to-day practice in the Emergency Department at the University of Mississippi Medical Center as well as into the curriculum for the residents and the research activities of the department.
The Emergency Department has three Sonosite X-Porte and three Sonosite M-Turbo ultrasound machines for exclusive use in the Emergency Department. The faculty and senior residents are very experienced in the operation of these machines in a variety of clinical pathology including trauma, cardiac, hepatobiliary, vascular, ocular, obstetrical, gynecological, urological and musculoskeletal. Ultrasound is also extensively used for procedural guidance and is an integral part of the evaluation of undifferentiated hypotension.
Emergency ultrasound training represents a significant part of the residency curriculum. Interns receive a full day focused on Point of Care US (POCUS) training during their OPEM month. Didactic sessions on POCUS are presented as a part of the regular conference schedule throughout the year. Each resident spends 2 weeks on the ultrasound rotation during the PGY1 year and again during PGY 2 year. This is a time of focused instruction and practice on POCUS. The two week course consists of Monday Ultrasound Conferences where time is spent discussing technical understanding, procedural competency, and diagnostic interpretation of images. Additionally, time is spent reviewing some of the latest images obtained in the department as part of the Quality Assurance process. Weekday afternoons are spent in the Emergency Department obtaining images with bedside instruction from the US directors and fellows. The PGY 2 resident is expected to lead an US journal club on the second weekly US Conference as well as work on bedside teaching skills during the rotation. Medical students as well as residents and fellows from other specialties rotate on our well-respected elective and we expect our residents to continue to be at the forefront with point-of-care ultrasound at our institution. The rotation concludes with a final examination review conference.
The Department of Emergency Medicine has also been active in emergency ultrasound research and publications. Recent projects have included including knee and ankle evaluations, POCUS for primary care providers, prehospital trauma evaluation, dehydration evaluation and sideline sports medicine applications.