Universitat Internacional de Catalunya
Clinical Ultrasound Applications in Medical Practice
Other languages of instruction: English, Spanish,
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Dr. Xavier Esquirol Puig puig1991@mac.com
Introduction
- In recent years, Clinical Ultrasound has acquired a great preponderance in the daily medical practice at the bedside of patients and has become an indispensable complementary tool in the daily monitoring of our patients. Its usefulness should NOT be based on diagnosis, but as an aid to physical exploration and evolutionary control of what is happening on a day-to-day basis after applying a specific exploratory or therapeutic action, without the need to mobilize or displace the patient.
- Nowadays, practically all the specialists are using it and it has stopped being something exclusive and limited to a certain group of doctors.
- In a short time, without a doubt, it will become an inexcusable and obligatory part in the formation of the different specialties, both medical and surgical. Some Universities are already incorporating it into their training programs from third, fourth or fifth year and there are numerous publications in this regard that support its usefulness.
- Being pioneers in any project always entails difficulty and overcoming barriers that until now were considered insurmountable, but anticipating being part of a select group that in the future, now very close, will cease to be,it is a challenge and a stimulus for teachers As for students.
Pre-course requirements
- The student must have completed all the subjects of Structure and Function of the curriculum of the Degree in Medicine.
- The knowledge of all those subjects related to anatomy and physiology will be basic to understand and relate an ultrasonic image to the real anatomical perception to which students are accustomed.
- A good spatial orientation will be basic to assume and internalize what is perceived through the information provided by an ultrasound transducer.
Objectives
The main objective of this subject is:
- Acquire the knowledge, skills and attitudes necessary to practice ultrasound techniques in a scientific, updated, safe and effective way, taking into account the latest scientific advances.
- Know how to relate the clinic to exploration (both physical and ultrasound).
- Give the student enough notions to be able to demonstrate in a very short space of time if what happens to a specific patient needs urgent action.
- Interpret, understand and distinguish between banal and important. Relate the findings of this technique with the signs and symptoms that a certain patient has.
Competences/Learning outcomes of the degree programme
- 05 - Recognize own limitations and the need to maintain and upgrade professional skills, with particular emphasis on autonomous learning of new knowledge and skills and motivation for quality.
- 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
- 21 - Listen carefully, obtain and synthesize relevant information about the problems affecting the patient and understand the contents of this information.
- 23 - Communicate effectively and clearly, both orally and in writing with patients, family members, media and other professionals.
- 34 - Ability for critical thinking, creativity and constructive skeptisim with a focus on research within professional practice.
- 35 - Understand the importance and limitations of scientific thinking in the study, prevention and treatment of disease.
- 36 - Be able to formulate hypotheses, collect and critically evaluate information for problem solving using the scientific method.
Learning outcomes of the subject
At the end of the course the student will be able to:
- Manage in general a portable ultrasound equipment and know the fundamentals of imaging in the different modes of ultrasound.
- Distinguish between the anatomical normality of the ultrasonic abnormality.
- Know the most relevant and current clinical and diagnostic aspects of Clinical Ultrasound.
- Show skills in the methodology of diagnostic work and other ecoclinical applications.
- Identify from the ecoclinical point of view cavities and structures.
- Perform a basic echocardiographic and clinical assessment, identifying the morphological and functional alteration of the diseased heart and knowing how to correlate it adequately with the acute event that decomposes it.
- Know how to diagnose, without a doubt, a pneumothorax, a pleural effusion or a condesation. All this, always from the eco-clinical point of view. Know how to relate lung and heart and identify what is the preponderance of one or the other with what happens to your patient.
- Know clearly the ultrasonic and clinical normality of the abdominal viscera.
- The student will be able to distinguish between arteries and veins, will know anatomically and ecoclinically where to find the main vascular pathology: deep venous thrombosis, aortic aneurysm, ...
- Be able to perform EcoFast in a few minutes to establish the best therapeutic solution.
Syllabus
CE1 - General management of portable ultrasound equipment and know the fundamentals of imaging in the different modes of ultrasound.
CE2 - Introduction to Clinical Echocardiography (Basic Echocardiography). Main plans and windows. Identification of cavities and structures.
• CE2.1 - Basic echocardiographic assessment: left ventricular systolic and diastolic function, pericardial effusion, measurement of the left atrium, estimation of ventricular hypertrophy, right ventricular function and pulmonary hypertension, approach to the patient with valvulopathy.
• CE2.2 - Usefulness of ultrasound in the diagnosis and treatment of patients with heart failure.
CE3 - Thoracic ultrasound. Main artifacts Identification of pleura and diaphragm. Relationship of the lung with other noble structures, supra and infradiaphragmatic, from the ecoclinical point of view.
• CE3.1 - Ultrasonic differences between pleural effusion, atelectasis, empyema, lung abscess. Pathognomonic signs of pneumothorax.
• CE3.2 - Ultrasound characteristics of pneumonia. Pulmonary condensation, hepatization Alveolo-interstitial syndrome and bronchioloalveolar space occupation.
• CE3.3 - Thyroid. Structure and its relation to the upper airway and large vessels of the neck.
CE4 - Ultrasound of the different peripheral vascular territories. "Trigger" areas where pathological defects must be sought.
• CE4.1 - Usefulness of ultrasound in the patient with suspected thromboembolic disease: deep venous thrombosis and pulmonary embolism.
• CE4.2 - Speeds and flows in arterial circulation.
CE5 - Identification of large vessels. Aorta and Cava.
• CE5.1 - Diagnosis of abdominal aortic aneurysm.
• CE5.2 - Diameter of the Lower Vena Cava, variability with respiratory movements and interpretation of the vollemia and need for fluid supply. Jugular veins.
• CE5.3 - Usefulness of ultrasound in the assessment of patients with hypotension and shock.
CE6 - Liver and gallbladder. Location and morphology of the bile duct. Spleen, structure and its relationship with pleura, aorta and kidney. Urinary bladder and kidneys. Douglas, seminal vesicles, prostate and uterus.
• CE6.1 - Evaluation of the gallbladder and bile duct: cholelithiasis, cholecystitis, cholestasis.
- CE6.2- Structure and ecoclinical morphology of the kidneys; relationship with liver, spleen and large abdominal vessels. Morrison space identification and spleno-renal recess.
• CE6.3 - Rapid diagnosis of acute hydronephrosis and acute urine retention. Ultrasound assessment of the patient with acute renal failure.
CE7 - Eco-Fast. Structures to identify for a correct orientation of the critical patient.
- CE7.1 - Learn to detect free intraperitoneal and / or pericardi al fluid.
• CE7.2 - Basic areas and location points for a correct interpretation in a minimum and adequate time.
CE8 - Brief introduction to basic interventional ultrasound.
• CE8.1 - Differences between the transverse and longitudinal approach.
• CE8.2 - Vascular, pleural, abdominal and pericardial approach.
Teaching and learning activities
In person
- Classes will always be face-to-face and will consist of a non-extensive theoretical part and another practice with the ultrasound.
- The theoretical classes will always be impregnated within the practice with the ultrasound, will be of short duration and based on a broad iconographic support of images and videos, basic in any case in this subject, to facilitate the student's understanding and subsequent staging during the same class. The objective of this is to carry out the practice immediately after the theoretical exposition.
- The students will practice among themselves to know the ecoclinical normality of the different structures under study. In addition, to facilitate learning in the detection of pathologies and from the point of view of Applied Clinical Ultrasound, a bank of images and videos will be available through which students can familiarize themselves, in an absolutely relevant and absent of any risk, with which in the future they will be in the daily clinical practice.
- Throughout the course, in addition to the above, students will have in the same room where classes are taught and practices are carried out, different ecosensitive material to directly experience what has been assimilated in previous days. Students will be aware of it on the same day or on short notice due to logical availability problems.
- It is highly recommended and desirable to attend all classes with comfortable clothes and predisposition.
Evaluation systems and criteria
In person
To pass the subject, the student must attend all classes and show during them the theoretical-practical assimilation of the knowledge taught, for which they must pass a theoretical assessment type test at the end of the semester and a practical test with the ultrasound.
- Test type test (40%)
- Practical exam (60%)
- To pass the subject, students must obtain a grade equal to or greater than 5, not being essential to pass the two evaluation elements separately.
Bibliography and resources
- In principle, we do not recommend specialized bibliography, because with the theoretical teaching material provided throughout the course we understand that it is more than enough.
- There are no books or specific bibliography in clinical ultrasound. In any case, there is not in those who combine all the material that is exposed throughout the course at once.
- In any case, if there are specially motivated students during the time the classes are taught and they request it, they will be duly helped and documented.