UUSSPPLLSS BBLL11 ~~ PPRROOVVIIDDEERR

UULLTTRRAASSOOUUNNDD

PPEEDDIIAATTRRIICC LLIIFFEE SSUUPPPPOORRTT 'USCMC LEVEL 1’ CERTIFICATION SKILL SET

ENTRY COURSE FOR ‘USPLS BL1-P’ [ULTRASOUND PEDIATRIC LIFE SUPPORT - BASIC LEVEL 1 - PROVIDER]

VVeerroonnaa,, 2288--2299 NNoovveemmbbrree 22001122

HHootteell SSaann MMaarrccoo VViiaa LLoonngghheennaa,, 4422 -- VVeerroonnaa

www.winfocus.org

CCOOUURRSSEE DDIIRREECCTTOORR

Stefano Marzini, Verona

CCOOUURRSSEE CCOO--DDIIRREECCTTOORR

Gian Alfonso Cibinel, Torino

CCOOUURRSSEE FFAACCUULLTTYY

Amedeo Bianchini, Bologna

Ersilia De Curtis, Prato

Giuseppe Limoli, Lodi

Stefano Marzini, Verona

WWIINNFFOOCCUUSS CCOONNTTAACCTTSS

Secretariat Office

Via Orefici, 4 - 40124 Bologna, ITALY

Tel +39 051 230385

Fax +39 051 221894

secretariat@winfocus.org

www.noemacongressi.it

www.noemacongressi.it/english.html

Executive Office – Board

Via Borgonuovo, 4 - 20124 Milano, ITALY

Tel +39 333 5404074

Fax +39 02 700531930

winfocus@winfocus.org

www.winfocus.org

““ CCRRIITTIICCAALL UULLTTRRAASSOOUUNNDD””

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 environments, disaster scenes, tactical operations, and humanitarian care missions. 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).

WWIINNFFOOCCUUSS ((WWoorrlldd IInntteerraacctt iivvee NNeettwwoorrkk FFooccuusseedd OOnn CCrrii tt iiccaall UUll tt rraaSSoouunndd)) 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.

WWIINNFFOOCCUUSS VViissiioonn aanndd MMiissssiioonn SSttaatteemmeennttss 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.

MERCOLEDì 28 NOVEMBRE 2012

INIZIO CORSO

8,00-8,30 Registrazione

8,30-8,50 Winfocus, US Point-of-Care e Focused US. Obiettivi del Corso

Stefano Marzini, Verona

8,50-9,00 Test pre-Corso

INTRODUZIONE ALLA ECOGRAFIA

9,00-9,30 Cenni di fisica del suono. Acquisizione immagini e interpretazione.

Utilizzo dei comandi di base

Stefano Marzini, Verona

AIRWAY - Valutazione

9,30-10,00 Tecnica ecografica, punti di repere, valutazione VVAA, assistenza e verifica intubazione,

riempimento gastrico

Amedeo Bianchini, Bologna

BREATHING - Valutazione

10,00-10,30 Tecnica ecografica, punti di repere, polmoni normali, principali quadri patologici acuti

(versamento pleurico, pnx, polmonite, sindrome interstiziale, atelectasie)

Stefano Marzini, Verona

CIRCULATION - Valutazione / CUORE

10,30-11,00 Tecnica ecografica, punti di repere, cuore normale, principali quadri patologici

(dilatazioni, ipertrofie, versamento pericardico, segni di ipertensione polmonare, miocardiopatie)

Giuseppe Limoli, Lodi

11,00-11,15 BREAK

US HOT - 1 Esercitazioni su Knobology, Airway, Breathing, Circulation-c

11,15-13,15 N. 4 stazioni da 30’ cad.

Amedeo Bianchini, Bologna - Giuseppe Limoli, Lodi - Ersilia De Curtis, Prato

13,15-14,15 LUNCH BREAK

CIRCULATION - Valutazione / VASI

14,15-14,45 Tecnica ecografica, punti di repere, visualizzazione vene periferiche e centrali, VCI, accesso

vascolare eco guidato\assistito

Stefano Marzini, Verona

EXPOSURE - Valutazione

14,45-15,15 EFAST, versamento addominale, vescica, ecografia integrata, lesioni maggiori ARTI

Ersilia De Curtis, Prato

US HOT - 2a Esercitazioni su Circulation-v, Exposure, Phantom accesso vascolare

15,15-16,15 N. 4 stazioni da 30’ cad. con due rotazioni

Stefano Marzini, Verona - Giuseppe Limoli, Lodi - Ersilia De Curtis, Prato

16,15-16,45 BREAK

US HOT - 2b Esercitazioni su Circulation-v, Exposure, Phantom accesso vascolare

16,45-17,45 N. 4 stazioni da 30’ cad. con due rotazioni

Stefano Marzini, Verona - Giuseppe Limoli, Lodi - Ersilia De Curtis, Prato

17,45-18,00 DOMANDE E COMMENTI

GIOVEDì 29 NOVEMBRE 2012

INIZIO CORSO

8,30-8,45 Presentazione della giornata e informazioni generali

Stefano Marzini, Verona

A-B-C-D Procedure invasive eco-assistite\eco-guidate

8,45-9,30 Tecnica ecografica, punti di repere, A: cricotomia - B: toracentesi, drenaggio PNX

- C: IO, CVC, CPR - D: rachicentesi

Amedeo Bianchini, Bologna

CASI CLINICI Visualizzazione di clips, analisi della tecnica ecografica e diagnosi POC

da parte dei discenti

9,30-11,00 Discussione interattiva

Giuseppe Limoli, Lodi - Stefano Marzini, Verona - Ersilia De Curtis, Prato

11,00-11,30 BREAK

US ABCDE. Primary management. Discussione interattiva

11,30-11,50 Gestione integrata. Arresto intraospedaliero

Amedeo Bianchini, Bologna

11,50-12,10 Gestione integrata. Insufficienza respiratoria acuta - dispnea

Stefano Marzini, Verona

12,10-12,30 Gestione integrata dello shock

Giuseppe Limoli, Lodi

12,30-13,00 Gestione integrata del trauma severo

Ersilia De Curtis, Prato

13,00-14,00 LUNCH Break

US HOT - 3 Esercitazioni su CPR, shock, trauma, dispnea

14,00-16,00 N. 4 stazioni da 30’ cad.

Stefano Marzini, Verona - Giuseppe Limoli, Lodi - Ersilia De Curtis, Prato

16,00-16,30 BREAK

US ABCDE Secondary management

16,30-17,00 Management e monitoring (concetti base)

Stefano Marzini, Verona - Amedeo Bianchini, Bologna

CHIUSURA DEL CORSO

17,00-17,15 Sottolineatura dei messaggi più importanti

17,15-17,45 Questionario di valutazione e apprendimento

17,45-18,00 Questionario di gradimento del corso (ECM) e valutazione interna

Amedeo Bianchini, Bologna

18,00-18,15 Note su certificazione, provider e istruttore, centri di formazione WF

Stefano Marzini, Verona

18,15-18,30 CONCLUSIONE E CONSEGNA ATTESTATI DI PARTECIPAZIONE

UUSSCCMMEE GGLLOOBBAALL PPRROOGGRRAAMM DDIIRREECCTTOORRSS::

Chair: Luca Neri (Milan, Italy) Co-chairs : Richard Hoppmann (Columbia, SC, USA), Enrico Storti (Milan, Italy) Advisors: Michael Blaivas (Atlanta, GA, USA): Winfocus President, RESCUE & ILCEUS Chair

Daniel Lichtenstein (Paris, France): Winfocus Scientific Comm. Chair

UUSSCCMMCC LLEEAARRNNIINNGG CCOONNTTEENNTTSS aanndd FFOORRMMAATT ::

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).

UUSSCCMMCC EEDDUUCCAATTIIOONNAALL CCEERRTTIIFFIICCAATTIIOONN RROOAADDMMAAPP ::

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 (US Trauma Life Support, ATLS-conformed) • EFAST (Extended Focused Assessment with Sonography for Trauma)

• US-ACLS (US Cardio-Pulmonary Life Support, ACLS/ALS-conformed) • US-BLSD (US Cardio-Pulmonary Life Support, BLS/LSD-conformed)

• US-NPLS (US Neonatal & Pediatric Life Support, PALS-conformed) • US-PHLS (US PreHospital Care & Disaster Medicine Triage)

• US-Triage (US Triage in Disaster Medicine)

• CC ECHO (Critical Care Echocardiography or ECHO ICU) • US-MON (US ABCDE Monitoring) • US-SEPS (US Sepsis Management)

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

• US-AIR (US Airway Management) • US-CVA (US Central Vascular Access Management) • US-PVA (US Peripheral Vascular Access Management) • US-BLOCK (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)

UUSSCCMMEE AAUUDDIIEENNCCEE TTAARRGGEETTSS ::

- 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

UUSSCCMMCC CCEERRTTIIFFIICCAATTIIOONN ~~ UUSSLLSS BBLL11 && AALL11 ffoorr PPRROOVVIIDDEERRSS