Department of Medicine, University of Calgary, Calgary, AB, Canada.
W21C, University of Calgary, Calgary, AB, Canada.
J Gen Intern Med. 2017 Sep;32(9):1052-1057. doi: 10.1007/s11606-017-4071-5. Epub 2017 May 11.
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.
床边即时超声检查(POCUS)越来越多地用于评估内科患者。目前,对于内科住院医师培训项目适合什么样的 POCUS 课程还没有共识。本文件详细介绍了由加拿大内科超声(CIMUS)小组提出的基于共识的建议,该小组由 39 名成员组成,代表加拿大 14 个机构。选择课程内容的指导原则是预先确定的。共识的定义是,至少 80%的成员认为 POCUS 应用程序适合核心(内科住院医师培训第 1-3 年)和扩展(普通内科住院医师培训第 4-5 年)培训计划中的学员教学和评估。我们建议在核心 PGY 1-3 课程中设置四个 POCUS 应用程序(下腔静脉、肺部 B 线、胸腔积液和腹部游离液)和三个超声引导程序(中心静脉导管插入术、胸腔穿刺术和腹腔穿刺术)。对于扩展的 PGY 4-5 课程,我们建议增加另外七个应用程序(颈内静脉、肺部实变、气胸、膝关节积液、左心室整体收缩功能、心包积液和右心室应变)和四个超声引导程序(膝关节穿刺术、动脉置管术、动脉血气采样术和外周静脉置管术)。这些建议将为国家级培训计划提供一个框架。