Advancing Emergency Department Ultrasound
By Dr. Jonathan Theoret, MDCM
Few new technologies have revolutionized the practice of emergency medicine more than bedside ultrasound. Ever since I witnessed my first FAST exam, I have been absolutely fascinated by the ability to “see inside the body”, right there, right now at the patient’s bedside. As a young medical student keen to embark on a career in emergency medicine, it seemed to me like “this was the future”. Why on Earth would I ever blindly approach a patient’s neck with a giant needle without knowing exactly where the vessel I am aiming for is located? Why would I pretend to hear the aortic stenosis murmur when I could learn to measure the valve area? This was six years ago… and today my excitement for bedside ultrasound has only grown stronger. Yet as a resident in the newest recognized medical specialty, obtaining advanced training in this subspecialty discipline is a major challenge in Canada. Many Canadian residency programs and major hospitals still do not have “local experts and advocates” for bedside ultrasound.
Machines like Sonosite's Nanomaxx continue to advance patient diagnosis.
So this is how my southbound quest began… a quest that led me to spend the 2009-2010 academic year as a “hybrid” fourth-year emergency medicine resident at the University of Alberta and emergency ultrasound fellow at Denver Health Medical Center, in Colorado. The story began when my colleague Dr. Geoff Sanz and I embarked on a road trip from Toronto in November 2008. We were on our way to Chicago to attend the American College of Emergency Physicians Annual Scientific Assembly. The eight-hour rainy drive proved to be a great opportunity to brainstorm about future career goals and mainly what we would utilize the subspecialty-training year of our residencies for. We were both interested in emergency ultrasound, but all fellowship opportunities in the United States involved a PGY-6 year after graduation. Unfortunately this left our fourth-year dilemma unsolved. Over the next few months, extensive discussions with our respective program directors, the Royal College Specialty committee and many fellowship directors in the US took place. A strategy to make a PGY-4 “hybrid training year” reality was devised.
After hours of long distance phone interviews, Geoff and I embarked on an epic North American tour, in January 2009. This interview took us from Colorado to South Carolina to Florida and New York. We interviewed for our “hybrid fellowship positions” and met some extraordinary leaders in emergency medicine bedside ultrasound. After extended and difficult deliberations, we elected the Denver Health Medical Center ultrasound fellowship, led by Dr. John Kendall. A few months and pounds of paperwork later, two PGY-4 ER residents from two different programs in opposite ends of Canada moved to Colorado.
So far the experience has been nothing short of extraordinary! Dr. Kendall is an internationally recognized leader in emergency ultrasound. He published numerous papers and authored one of the leading textbooks in the field of bedside sonography. The chance of getting one-on-one teaching by such a respected expert is truly unparalleled. Dr. Kendall’s knowledge and motivation has created a clinical environment with very high “buy-in” of ultrasound technology. The Denver Health emergency medicine residents and attendings are all extremely proficient in basic and advanced uses of ultrasound. As such bedside sonography is used multiple times per shift to assist in, and often drastically alter, clinical management plans. The training Geoff and I are obtaining is invaluable and will certainly further bedside sonography upon our return home to Canada.
With this in mind, it is with great pride that Track & Trail Adventures announces the upcoming 2010 Whistler Ultrasound Conference, a four-day multi-sports adventure, based at The Fairmont Chateau Whistler. From July 14th to the 18th, 2010, Dr. Kendall will bring the entire team of Rocky Mountain Ultrasound for a one-of-its-kind ultrasound course. It will offer 16 hours of accredited CME, with separate educational tracks for pediatric, critical care, and adult emergency medicine ultrasound. Sign up for Track & Trail's monthly e-news to get the latest details to be released soon. Adventure opportunities will include golfing four of the highest rated courses in North America, mountain biking the best trails in the world, climbing Whistler peak through the via ferrata and hiking through Singing Pass and some of the most unbelievable alpine meadows British Columbia has to offer.
Stay tuned as Track & Trail Adventures continues to design unique ways to fuel your passion and your profession.
