247TF The EndoVaginal Ultrasound Module

Abstract

Ultrasound has become a ubiquitous technology in the emergency department. One specific subset of bedside ultrasound skills that can be difficult to develop, however, is endocavitary ultrasound. This is typically due to unfamiliarity with the probe itself and the invasive nature of the procedure. Oftentimes, this discomfort results in the ordering of radiology-performed scans which can lead to delays in diagnoses and increased costs incurred by the patient. This instructional module was developed to improve emergency medicine resident comfort with image acquisition and interpretation using the endocavitary probe while on their ultrasound rotation. The purpose of this instructional module is to improve emergency medicine residents’ understanding and knowledge of pelvic anatomy as well as technical skill with using the endocavitary ultrasound probe. It is also to apply knowledge of pelvic anatomy and bedside ultrasound skills to the common situation of appropriately evaluating a woman with first trimester vaginal bleeding. The instructional module will begin with a short pre-test including 5 separate clinical scenarios followed by ultrasound images. After this, there is a presentation meant to be reviewed by the learner(s) prior to arrival for the in-person session. Subsequently, the resident will be led through a directly proctored session reviewing handling of the endocavitary probe and how to navigate optimal image acquisition. Finally, there will be a post-test involving both a manikin with abnormal pelvic anatomy and then 10 more clinical scenarios. After completion of this module, emergency medicine residents will be able successfully obtain images using the endocavitary ultrasound probe. They will also be able to apply the information obtained with these images to patient management when treating a 1st trimester vaginal bleed.