The Emergency Ultrasound Division promotes the use of bedside ultrasound in the evaluation and management of patient in the emergency department. Using portable technology and goal-directed exams, we can assess basic cardiac function, abdominal pain, and thoracic disorders at the bedside. Ultrasound is also widely employed to assist in bedside procedures such as central and peripheral venous access, paracentesis, abscess aspiration, and others.
Emergency Medicine residents undergo a dedicated bedside ultrasound rotation during their intern year, and a course is available for medical students as well. Current ultrasound research in the department focuses on pneumothorax detection, ectopic pregnancy evaluation, and assessment of deep vein thrombosis.
The Mount Sinai Hospital
The Division's educational website, records more than 70,000 annual page views from more than 100 countries. The educational videos and ultrasound tutorials on our YouTube channel have over 75,000 views and over 800 subscribers. The Division, in collaboration with Cardiology, runs a longitudinal ultrasound curriculum for medical students. During the Gross Anatomy course, students are exposed to the dynamic anatomy of the moving heart to augment their dissections. Surface anatomy dovetails with ultrasound assessments of vessels and joints, revealing the anatomy beneath the skin surface. The physical examination course (PREP) contains basic ultrasound assessments focused on anatomy (year 1) and common pathological states (year 2). All fourth-year students are trained in basic cardiovascular assessment using ultrasound as part of the Introduction to Internship course.
The Division also runs an emergency ultrasound elective for third and fourth-year students, and organizes an ultrasound orientation for all students rotating through the Emergency Medicine elective. A two-week ultrasound rotation is mandatory for all first-year Emergency Medicine residents, and introductory courses in ultrasound have been offered to residents from emergency medicine, internal medicine, obstetrics, and family medicine.
Our Division is a leader in point of care ultrasound through the hospital, and we have trained physicians, nurses, physician assistants, and nurse practitioners in the use of ultrasound for diagnosis and procedure guidance. We have created educational modules and trained members of Internal Medicine, Gastroenterology, Pediatrics, the hospital sepsis team, and others. We have worked with our Simulation Division to create and apply a risk reduction program for ultrasound-guided central venous access.
A CME course in Emergency Ultrasound has been offered at Mount Sinai annually since 2005. In addition, each year our faculty lecture at dozens of courses throughout the world, including all major emergency medicine societies. Bret Nelson and Jim Tsung are on the Board of Directors of the international ultrasound organization WINFOCUS and have organized courses through them as well. Bret Nelson is past Chair of the American Institute for Ultrasound in Medicine Point-of-Care Community of Practice, and organizes educational sessions at their annual conference.
Mount Sinai St. Luke’s and Mount Sinai West
Our division teaches bedside ultrasound to two fellows, 42 residents, and about 50 rotating medical students each year at Mount Sinai St. Luke’s and Mount Sinai West. In the last several years we have built on the residency educational curriculum by incorporating innovative educational modalities such as podcasts, and added a monthly guest educator series with teaching faculty from around the country.
Because residents are graduating from Emergency Medicine residency competent in basic ultrasound skills, our goals for fellowship education continue to evolve. Our aim is to provide fellows with not only advanced ultrasound skills but also the tools to become successful academicians and leaders. We have worked to build relationships with other academic divisions including Global Health and Simulation, and expanded opportunities for interactions with departmental leadership, residency leadership, industry, information technology, coding and billing, and other hospital services. We also have dedicated education aimed at lecture preparation, preparation of images for scholarly submission, authorship, and how to run an ultrasound conference. Since 2014, we have been working with educators at the Catholic University of Mozambique. There, we have been actively involved in the education of fifth-year medical students with an ongoing remote educational curriculum and quality assurance program.
Our educational efforts also include the ongoing quarterly round-table format City-Wide Ultrasound Grand Rounds and an annual symposium each spring with invited guest lecturers and a research forum for fellows. In 2016, because of years of continued increased attendance, we will hold the conference in the Stern Auditorium at The Mount Sinai Hospital.
A number of clinical and educational research projects are underway. These include assessments of medical student and internal medicine residency curricula in ultrasound; assessment of congestive heart failure using handheld ultrasound; the utility of intravascular contrast on cardiac sonography; a multi-system shock assessment; investigation of a novel vascular resistance assessment device in dyspnea, and many others. These projects include Division faculty, ultrasound, and Pediatric Emergency Medicine fellows, and Emergency Medicine residents.