Point of Care Ultrasound Handbook

Guest Post by Jason Bowman, EM Resident

You want to be better with point-of-care ultrasound, right? Who doesn’t? If you’re like me, you’ve got a handful of core exams you do regularly, but you often find yourself having trouble remembering the specifics of some less frequently performed exams. Do you get tired of spending the time to learn a new exam, only to not feel comfortable enough remembering the details when the time comes? Or maybe you’re just starting out with ultrasound, are overwhelmed and struggling to discern which exams you should learn now and which should be left for later. Regardless of your current skillset, if you’re here, then it’s likely that you’ve realized ultrasound, when used properly, is a powerful tool to help you take better care of your patient and be more confident in the care you’re providing. You just need help bridging that gap.

Ultrasound is often maligned as being highly user dependent. It absolutely is. However, the physical exam has the same shortcomings, yet we still teach that without a second thought. Problems arise with both of these modalities when you’re presented with the need to perform a high complexity, low frequency task. Ultrasound has a lot of these. Fortunately, there are resources to help you. When I ran a prehospital ultrasound program, I wanted something my paramedics could refer to in the truck while doing the exam. But nothing like that existed, so I designed my own. I wanted it to be super simple and visual, so all they had to do was flip to the appropriate page and it would tell them what settings to use, what depth to dial in, where to place the probe, what buttons to push and the steps necessary to do the exam. It would also show them how to interpret the exam findings, the important numbers to measure, what good looked like and what bad looked like. Even though I wrote this book for them, I’ll be honest, there were many times at 2:00 am I still had to look stuff up. There’s no shame in this; that’s just how our brains work.

When my friends Jason Boitnott and Branden Miesemer came along, we started EMSPOCUS. With the goal of training the masses in point of care ultrasound using high quality, adult learning theory focused educational methods, we realized finishing this book was one of the best ways to start doing that quickly. After nearly a decade of working on it, we published it over the summer of 2017 right before DasSMACC. Over the course of its development, from 2009 to 2017, we’ve taken a lot of input from the FOAMed community into creating what is now the first edition. This book truly is a product of the FOAMed community and absolutely would not have been possible without it! Which is one of the main reasons we are so excited to start releasing sections of the book back to the FOAMed community from which it was born.

Today, in homage to our friend Scott, we want to show you our take on the RUSH exam. This is a great place to start as it’s virtually the one stop shop of things that are gonna kill your patient dead right now. If you’ve never seen this exam before, have no fear, our book still has the soul of one that started off life as a field guide for medics to reference at 2:00 am. Each view is only 1-2 pages and packed with visuals. But this book isn’t limited to just medics. We sought out feedback from medical students, nurses, residents and even physician attendings, ranging in specialties from emergency medicine to critical care and internal medicine. In response, we crammed each page full of widely applicable tips and tricks for both the novice and advanced user. This book is designed to grow with you, in a package small enough to fit in your pocket. While this isn’t meant to be your primary textbook, having it available for quick reference every day is the best way to maximize your incidental learning, which happens to be one of the most powerful methods of adult learning. There’s even a quick reference of measurements on the back cover so you don’t even have to open it to use it, plus we’ve added pages for notes throughout so you can make it your own.

Please, enjoy our RUSH exam section; we hope you find it useful.

RUSH Chapter from the Book

If you like it, our full book is currently available.

Feel free to contact us for discounts on bulk orders. And if you are an EMS agency in need of ultrasound training, please contact us at emspocus.com. We put just as much work into our unique ultrasound training program as we have our book. Until next time, happy scanning.

– Jason Bowman & the EMSPOCUS crew

Jason Bowman MD, MS, FF/CCEMTP (@texprehospital) – Jason is currently an emergency medicine resident at the University of Kentucky. He is a co-founder of the EMSPOCUS group and previously spent 10 years as a firefighter paramedic in Texas where he started one of the first paramedic run EMS ultrasound programs in the nation. Jason is also a cardiac arrest researcher and ran a pig lab for 7 years, you can follow his research at resuscitationist.com.