USLSBL1~PROVIDER

ULTRASOUND LIFESUPPORT

ABCDEULTRASOUND RESUSCITATION

August 15-16, 2012 ~ 08:30am – 05:30pm Bangkok - Thailand

King Chulalongkorn Memorial Hospital www.winfocus.org

Soft cadaver Vascular access Premium Certification Workshop  

AND  

CO U R S E DI R E C T O R S

Luca Neri MD Mahmoud Elbarbary MD

Suthaporn Lumlertgul.MD, Thailand

WI N F O C U S CO N T A C T S

         Secretariat Office Via Orefici, 4 - 40124 Bologna, ITALY        Tel +39 051 230385      Fax +39 051 221894  noema.secretariat@winfocus.org    www.noemacongressi.it

 Executive Office – Board Via Borgonuovo, 4 - 20124 Milano, ITALY

     Tel +39 333 5404074    Fax +39 02 700531930    winfocus@winfocus.org        www.winfocus.org

     RE G I S T R A T I O N  ONLINE REGISTRATION: Go to http://www.winfocus.org/registration, make your choice and follow the procedure.  OFF-LINE REGISTRATION: Find attached or download the form at http://www.winfocus.org/registration, then send it by FAX to +39 051 221894 or by EMAIL to noema.secretariat@winfocus.org Or emchula@gmail.com            “CRITICAL ULTRASOUND”  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

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).

       WINFOCUS (World Interactive Network Focused On Critical UltraSound)  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.                WINFOCUS Vision and Mission Statements

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.

L O C A L CO U R S E DI R E C T O R S

CO U R S E I NSTRUCTORS

Luca Neri MD, Milan Italy Mahmoud Elbarbary MD, Saudi Arabia

Ton Hong Chuen MD, Singapore Mok Ka Leung MD, Hong Kong

Gordon Lee MD, HongKong Suthaporn Lumlertgul, Thailand

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First Day Second Day

08:00 REGISTRATIONS & PRE-COURSE TEST 08:00 REVIEW, DEBRIEFING, Q/A

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08:30 Point-of-care US in Primary, Emergency and Critical Care Medicine: empowering life support protocols

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08:30 ASSESSMENT:

Peritoneal effusion: FAST windows.

08:50 Critical ultrasound techniques: image generation, acquisition, interpretation & administration.

08:50

ASSESSMENT: N/ retro-peritoneal, parenchymal and soft tissue haematomas.

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09:10

ASSESSMENT: Obstruction/atelectasia, tracheal displacement and lesions, emphysema. Prandial status.

PROCEDURES: ETT, crico-tyroidotomy, tracheo-tomy/-stomy.

09:10

ASSESSMENT: Abdominal & thoracic aortic aneurysm: detection, measurement, N/ dissection and rupture.

09:30 MANAGEMENT: Airway Protocols & Interactive Cases [US-AIR]

09:30

ASSESSMENT: O&G emergencies: ectopic vs intrauterine, retroplacentar haematoma, placenta previa. Fetus: movements, heart beat, position, presentation.

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GG

09:50

ASSESSMENT:

Pleural effusion, alveolar consolidation, interstitial syndrome, pneumothorax. Diaphragm impairment.

09:50

PROCEDURES:

Defibrillation, TC & IV pacing.

Pericardiocentesis, pleurocentesis.

Paracentesis, DPL, laparotomy.

10:10

PROCEDURES: Needle aspiration, thoraco-centesis, chest tube insertion, thoracotomy.

10:10

PROCEDURES:

Peripheral & central venous catheterization.

10:30 MANAGEMENT: Respiratory Protocols & Interactive Cases [BLUE]

10:30 MANAGEMENT: Cardio-circulatory Protocols & Interactive Cases [FAST, EFAST, FAST-ABCDE, L/H/CV]

10:50 COFFEE BREAK 10:50 COFFEE BREAK

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11:10

ASSESSMENT: Introduction to echocardiography. Cardiac and caval vein windows.

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11:10

ASSESSMENT: Optic nerve sheath/disc, pupil assessment (+midline shift, cervical fracture, neonatal assessment).

MANAGEMENT:

Neurological Protocols & Interactive Cases [US-NEU]

11:30

ASSESSMENT: Critical hemodynamic assessment: heart morphology/performance/filling state, pericardial effusion/tamponade, caval vein variations.

AA BB CC DD EE

11:30

US ABCDE PRIMARY MANAGEMENT:

- US Trauma Life Support [US-TLS]

- US Advanced Cardiac Life Support [US-ACLS]

- US-Triage & US-EMS/HEMS

11:50

ASSESSMENT:

Thrombo-embolic disease: deep venous thrombosis, pulmonary embolysm.

HEAD

-TO-

TOES

11:50

CONCEPTS ON HEAD-TO-TOES SECONDARY MANAGEMENT & MONITORING:

- Head, Thorax, Abdomen, Limbs

- Assessment, treatment, monitoring, and follow-up

12:10

MANAGEMENT:

Cardio-circulatory Protocols & Interactive Cases [FEEL, FATE, L/H/CV]

CME 12:10 Ultrasound education and development: WINFOCUS global initiative for PHC, EM and CCM.

12:30 LUNCH 12:30 LUNCH

TRAINING

13:30

US HANDS-ON & SIMULATION:

[HUMAN MODELS, PHANTOMS & ULTRASOUND SIMULATOR]

Machine orientation.

Signs & patterns, sono-anatomy.

Airway, Breathing, Circulation.

TRAINING

13:30

US HANDS-ON & SIMULATION:

[HUMAN MODELS, PHANTOMS & ULTRASOUND SIMULATOR]

Circulation, Disability

Dyspnea, Shock, Coma

US Trauma Life Support [US-TLS]

US Advanced Cardiac Life Support [US-ACLS]

17:30 SESSION CLOSURE 17:30 POST-COURSE TEST & CLOSURE

USCME GLOBAL PROGRAM DIRECTORS: Chair: Co-chairs : Advisors:

Luca Neri (Milan, Italy) Richard Hoppmann (Columbia, SC, USA), Enrico Storti (Milan, Italy) Michael Blaivas (Atlanta, GA, USA): Winfocus President, RESCUE & ILCEUS Chair  Daniel Lichtenstein (Paris, France): Winfocus Scientific Comm. Chair  

USCMC LEARNING CONTENTS and FORMAT : 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).  USCMC EDUCATIONAL CERTIFICATION ROADMAP : 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 EFAST US-ACLS US-BLSD US-NPLS US-PHLS

US-Triage

CC ECHO US-MON US-SEPS

US-GPE US-PHC US-NURSE

US-AIR US-CVA US-PVA US-BLOCK

(US Trauma Life Support, ATLS-conformed) (Extended Focused Assessment with Sonography for Trauma) (US Cardio-Pulmonary Life Support, ACLS/ALS-conformed) (US Cardio-Pulmonary Life Support, BLS/LSD-conformed) (US Neonatal & Pediatric Life Support, PALS-conformed) (US PreHospital Care & Disaster Medicine Triage)

(US Triage in Disaster Medicine)

(Critical Care Echocardiography or ECHO ICU) (US ABCDE Monitoring) (US Sepsis Management)

(US General Practice in Emergency) (US Primary Health Care in scarce-resource-setting) (US Nursing care in Emergency)

(US Airway Management) (US Central Vascular Access Management) (US Peripheral Vascular Access Management) (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)

USCME AUDIENCE TARGETS : - 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