Careful Ultrasound Examination Research Articles

Impact of a Point-of Care Ultrasound Examination on the Management of Acute Respiratory or Circulatory Failure Patients in the Emergency Department: The Impulse Before-and-After Implementation Study

Background: Despite its diagnostic accuracy, the clinical impact of the use of Point-of-care Ultrasound (POCUS) in the emergency department (ED) is not well described, especially when performed by junior in-training residents. Aim of the study: To assess the effect of a short, structured POCUS training program on the management of ED patients by in-training residents. Method: IMPULSE is a before-and-after implementation study, evaluating the impact of a structured POCUS training program for ED in-training residents on the management of patients admitted for acute respiratory and/or circulatory failure in a Swiss regional hospital. The training curriculum was organized in three stages and combined an on-line training course, an 8-hour practical hands-on session, and 10 supervised POCUS exams. The ED residents who successfully completed the curriculum participated in the study. Observed outcomes were time to ED diagnosis, rate of correct diagnosis made during the ED stay and time needed to reach it, time to prescribe an appropriate treatment, and hospital mortality. Standard statistical analyses were performed with the use of Chi-square and Mann-Whitney U tests as appropriate, completed by a Bayesian analysis, with a Bayes Factor (BF) >3 considered as significant. Results: Sixty-nine patients were included before the training program implementation and 54 after. After implementation, the median time to ED diagnosis was 25 minutes (IQR 44) vs 30 minutes (IQR 56) before implementation, a difference that was significant (BF 9.6). The rate of correct diagnosis was higher (95 vs 52%) (p<0.001) and the time to make this correct diagnosis was significantly shorter after implementation (25 minutes, IQR 45, vs 43, IQR 60) (BF 5.0). This had an impact on the median time to prescribe the appropriate therapy, with a trend toward a shorter delay (47 minutes, IQR 76, vs 70, IQR 100) (BF 2.0). Eventually, there was a significant difference in hospital mortality (13% vs 5.5%, BF 15.7). Conclusion: The IMPULSE study shows that the implementation of a short, structured POCUS training program for ED residents to use ultrasound for the initial evaluation of acute respiratory and circulatory failure patients has an impact on diagnostic accuracy, on time to make a correct diagnosis and to prescribe an appropriate therapy, and eventually possibly on hospital mortality. If these results are reproduced in other settings, POCUS use by ED residents after short, structured training curriculum could become the standard of care for these patients.

Differential diagnosis and cause-specific treatment during out-of-hospital cardiac arrest: a retrospective descriptive study

BackgroundThe cardiopulmonary resuscitation (CPR) guidelines recommend identifying and correcting the underlying reversible causes of out-of-hospital cardiac arrest (OHCA). However, it is uncertain how often these causes can be identified and treated. Our aim was to estimate the frequency of point of care ultrasound examinations, blood sample analyses and cause-specific treatments during OHCA.MethodsWe performed a retrospective study in a physician-staffed helicopter emergency medical service (HEMS) unit. Data on 549 non-traumatic OHCA patients who were undergoing CPR at the arrival of the HEMS unit from 2016 to 2019 were collected from the HEMS database and patient records. We also recorded the frequency of ultrasound examinations, blood sample analyses and specific therapies provided during OHCA, such as procedures or medications other than chest compressions, airway management, ventilation, defibrillation, adrenaline or amiodarone.ResultsOf the 549 patients, ultrasound was used in 331 (60%) and blood sample analyses in 136 (24%) patients during CPR. A total of 85 (15%) patients received cause-specific treatment, the most common ones being transportation to extracorporeal CPR and percutaneous coronary intervention (PCI) (n = 30), thrombolysis (n = 23), sodium bicarbonate (n = 17), calcium gluconate administration (n = 11) and fluid resuscitation (n = 10).ConclusionIn our study, HEMS physicians deployed ultrasound or blood sample analyses in 84% of the encountered OHCA cases. Cause-specific treatment was administered in 15% of the cases. Our study demonstrates the frequent use of differential diagnostic tools and relatively infrequent use of cause-specific treatment during OHCA. Effect on protocol for differential diagnostics should be evaluated for more efficient cause specific treatment during OHCA.

Ultrasound Tomography (3D) Triage for Oculofacial emergencies- new paradigms

Background: The incidence of ocular trauma has been on the rise for the past few years. This impels the medical community to be more adroit at diagnosing and treating these injuries. An effective way to diagnose different manifestations of ocular trauma involve the use of ultrasound to visualize the anatomical details of the eye and orbit, which is vital for deciding the best management plan. Aim: To assess the suitability of 3D Ultrasound as a first-line investigation for oculofacial emergencies resulting from projectile and blast injuries. Methods: In this review article, the focus of discussion will be the accuracy of 3D ultrasound in diagnosing oculofacial injuries and the utility of ultrasound in triage of vision threatening emergencies in austere environments. Results: Understanding the utility of ultrasound data for diagnosis will assist ophthalmologists in managing ocular trauma more effectively. Conclusion: We recommend that patients with suspected eye injuries should undergo careful 3D ultrasound examination by appropriately trained ophthalmologists as a part of triage for oculofacial emergencies in austere environments.

Imaging Diagnosis of Testicular Lymphoma in Young Male Patient: Incidental Finding in Ultrasonography

BACKGROUND: Ultrasonography is a common diagnostic procedure in patients with testicular abnormalities. Primary testicular lymphoma (PTL) is rarely discovered and is more common among elderly populations. CASE PRESENTATION: This case describes a young male patient with a history of painless testicular enlargement. Ultrasonography reveals an incidental finding of hypoechoic echo structural mass and increased vascularity using color Doppler ultrasonography. The further pathological examination discovered the findings indicative of a non-Hodgkin, diffuse, and large B-cell lymphoma. These distinctive features should be helpful in suggesting a diagnosis of PTL on imaging. CONCLUSION: PTL is a rare and aggressive extranodal NHL. Despite its low incidence, it is an extremely rare testicular cancer at a young age. Careful ultrasound imaging examination should be applied in patients with testicular enlargement. The presence of hypoechoic echostructural and an increase in vascularity should be considered for the possibility of a diagnosis of primary testicular tumor.

A Guide to Point of Care Ultrasound Lung and IVC Examination of a Volume Overloaded Patient

A Guide to Point of Care Ultrasound Lung and IVC Examination of a Volume Overloaded Patient

A Guide to Point of Care Ultrasound Examination of Acute Decompensated Heart Failure

A Guide to Point of Care Ultrasound Examination of Acute Decompensated Heart Failure

A Guide to Point of Care Ultrasound Examination of a Pericardial Effusion

A Guide to Point of Care Ultrasound Examination of a Pericardial Effusion

Acquiring the Skills to Perform Point of Care Ultrasound of the Infant Hip Through Simulation

Developmental dysplasia of the hip (DDH) is the most common anatomical pathology in newborns. Traditionally, the standard physical exam for newborns includes hip stability testing using the Barlow and Ortolani maneuvers. If the pediatrician detects hip instability, then they are referred for a hip ultrasound—the gold standard for DDH diagnosis. We present our experience with a simulation model for teaching point of care ultrasound examination of an infant hip with which we have successfully and consistently taught numerous residents and attendings how to swiftly and accurately assess DDH in an infant's hip.

Breast Ultrasound Volume Sweep Imaging: A New Horizon in Expanding Imaging Access for Breast Cancer Detection.

The majority of people in the world lack basic access to breast diagnostic imaging resulting in delay to diagnosis of breast cancer. In this study, we tested a volume sweep imaging (VSI) ultrasound protocol for evaluation of palpable breast lumps that can be performed by operators after minimal training without prior ultrasound experience as a means to increase accessibility to breast ultrasound. Medical students without prior ultrasound experience were trained for less than 2 hours on the VSI breast ultrasound protocol. Patients presenting with palpable breast lumps for standard of care ultrasound examination were scanned by a trained medical student with the VSI protocol using a Butterfly iQ handheld ultrasound probe. Video clips of the VSI scan imaging were later interpreted by an attending breast imager. Results of VSI scan interpretation were compared to the same-day standard of care ultrasound examination. Medical students scanned 170 palpable lumps with the VSI protocol. There was 97% sensitivity and 100% specificity for a breast mass on VSI corresponding to 97.6% agreement with standard of care (Cohen's κ=0.95, P < .0001). There was a detection rate of 100% for all cancer presenting as a sonographic mass. High agreement for mass characteristics between VSI and standard of care was observed, including 87% agreement on Breast Imaging-Reporting and Data System assessments (Cohen's κ=0.82, P < .0001). Breast ultrasound VSI for palpable lumps offers a promising means to increase access to diagnostic imaging in underserved areas. This approach could decrease delay to diagnosis for breast cancer, potentially improving morbidity and mortality.

Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report.

IntroductionBleeding in the retroperitoneal space is a serious complication. Hypovolemia and shock develop late after losing a large volume of blood. However, point of care ultrasound (POCUS) examinations in adult patients with shock do not include the retroperitoneal space.Case presentationWe present the case of a 74-year-old male with ischemic heart disease on dual antiplatelet. He developed vague abdominal pain and hemoglobin drop without overt bleeding source until he developed shock. Modified POCUS examination that included the retroperitoneal space detected the bleeding source and confirmed later by computerized tomography of the abdomen. The case was managed conservatively.Clinical discussionThe risk factors associated with the formation of spontaneous retroperitoneal hematomas are age above 70 years and dual antiplatelet therapy. The initial integration of point-of-care ultrasound into the assessment of shocked patients leads to an earlier and accurate initial diagnosis with a clear patient care plan. POCUS should include the retroperitoneal space examination in every patient presenting with shock.ConclusionIn patients with unexplained hemorrhagic shock, a modified POCUS protocol could help by including an examination of the retroperitoneal space in the assessment.

Point of Care Ultrasound Examination for Pre-op Evaluation of Arteriovenous Access Patients

Introduction: Ultrasound examination is an essential component in the preoperative evaluation of patients needing creation of an arteriovenous access. This test is not usually incorporate as part of the initial outpatient visit. Point of care ultrasound examination as part of the initial physician visit decrease cost, generate a surgical planning, as a one-time stop before scheduling. We the experience of incorporation POCUS examination of the upper extremities, in the initial consultation visit of patients needing creation of an arteriovenous access. Methods: A retrospective review of a prospectively maintain database of dialysis access patients;from which data was collected from patients which have point of care ultrasound as planning imaging during their initial visit, and then underwent a surgical access creation. Data was extracted from periprocedural and clinical follow-up records. Results: Nineteen patients underwent point of care ultrasound examination at vascular surgery visit and underwent creation of an arteriovenous access. The mean age of patients 50.5 years (24-70 years). Twelve patients were male (63%), and seven patients were female (37%). An arteriovenous fistula was successfully created on 18 patients (95%). Thirteen patients are using their access for hemodialysis (68%). Conclusion: This preliminary study demonstrates that performance of POCUS examination by operating surgeon in office, is a suitable technique which allows for a successful rate for arteriovenous access creation, allowing savings in healthcare costs of the patient, allowing the visit as a one-stop evaluation and surgical planning. This study was performed during the COVID-19 pandemic.

To Access The Potential of Point of Care Ultrasound to Differentiate Various Causes of Dyspnea In Emergency Department

Management of the patients presented with dyspnea can be challenging in emergency department(ED), because differentiating underlying cause can be difficult and time consuming. Point of care ultrasound(POCUS) examination in early evaluation of critical patients have been reported to be helpful in rapid diagnosis of causes of dyspnea which in turn helps in early Resuscitation. Aim: We performed this study to assess utility of POCUS in differentiating causes of dyspnea &amp; compared with final diagnosis at the time of discharge/death. Settings and design: This was a single centre prospective diagnostic study to assess utility of POCUS in dyspnea. It was approved by ethical committee. Materials and methods: The study was conducted at ED of tertiary care government hospital in Central Gujarat from December 2018 to November 2019. All patients presenting with dyspnea to ED were included after written informed consent. Patients’ age &lt; 12 years, Patients not willing for admission, and Patient who took discharge against medical advice /absconded/died before establishing final diagnosis were excluded. Provisional diagnosis made through POCUS was compared with the final diagnosis made by the consultants of respective clinical departments during course of their hospitalization. Statistical analysis and results: 146 patients with dyspnea presenting to ED were included in prospective observational study. True and False positives, sensitivity and specificity were calculated from the analysis of data. Reliability index was calculated on the basis of above data. *Conclusion: This study showed good efficacy of POCUS in differentiating causes of dyspnea when compared with final medical diagnosis. Thus POCUS helps in early resuscitation and management.

Évaluation pronostique prénatale échographique de la myéloméningocèle à l’ère de la chirurgie fœtale

Myelomeningocele (MMC) is a severe congenital condition responsible for motor and sensory impairments of the lower limbs, incontinence and cognitive impairment. Its screening, sometimes as early as the first trimester, is one of the major goals of modern prenatal care, supported by the emergence of prenatal surgery that results in a significant improvement in motor function, ambulation and ventriculoperitoneal shunt rate in patients undergoing in-utero surgery. From screening to pre- and post-operative prognostic evaluation, prenatal ultrasound is now an essential tool in the antenatal management of this condition. Using the multi planar and three-dimensional modes, it can be used to assess the vertebral level of MMC, which remains the key antenatal prognostic marker for motor function and ambulation, incontinence and the need for a ventriculo-peritoneal shunt. A careful and systematic ultrasound examination also makes it possible to assess the severity and progression of ventriculomegaly, to search for associated cerebral, spinal cord or vertebral anomalies, or to rule out exclusion criteria for in-utero surgery such as severe kyphosis or serious cortical anomalies. New tools from post-natal evaluation, such as the “metameric” ultrasound assessment of lower limb mobility, appear to be promising either for the initial examination or after in-utero surgery. Ultrasonography, associated with fetal MRI, cytogenetic and next generation sequencing, now allows a highly customized prognostic evaluation of these fetuses affected by MMC and provides the parents with the best possible information on the expected benefits and limitations of fetal surgery.

Hepatic portal vein gas detected by point of care ultrasound.

IntroductionPortal venous gas is a rare finding in adults and is typically associated with underlying intestinal ischemia. Portal venous gas can be detected by a bedside point of care ultrasound (POCUS) examination in adult patients in critical care units (CCU). Findings include echogenic bubbles flowing centrifugally throughout the portal venous system.Case presentationWe present the case of a 73-year-old female with advanced ischemic cardiomyopathy and cardiorenal syndrome who was managed in the CCU. She developed vague abdominal pain and respiratory depression requiring intubation and dialysis during her course of treatment in the CCU. Her findings were consistent with portal venous gas upon POCUS, prompting computed tomography of her abdomen and surgical consultation. She was ultimately found to have nonobstructive mesenteric ischemia.Clinical discussionPVG is an ominous radiological sign and reflects intestinal ischemia in up to 72% of cases. Acute mesenteric ischemia of the small bowel could be due to occlusive or nonocclusive obstruction of the arterial blood supply or obstruction of venous outflow. Nonocclusive obstruction accounts for 5% to 15% of patients with acute mesenteric ischemia.ConclusionWith the increasing use of POCUS, critical care physicians should be aware of findings consistent with portal venous gas as a bedside tool for directing the treating physician toward an ominous diagnosis in patients with shock.

Utility of Point of Care Ultrasound in Humanitarian Assistance Missions.

Point of care ultrasound (POCUS) is increasingly used in primary care in the USA and has been shown to provide significant benefit to care in deployed military settings and during disaster relief efforts. It is less studied as a tool during humanitarian assistance missions. We sought to determine the utility of POCUS in a humanitarian assistance setting during the February 2019 joint U.S.-Brazilian hospital assistance mission aboard the Hospitalar Assistance Ship Carlos Chagas along the Madeira River in the Brazilian Amazon. Point of care ultrasound was offered as a diagnostic modality to primary care physicians during the course of a month-long mission. A handheld IVIZ ultrasound machine was loaned for use during this mission by Sonosite. A P21v phased array (5-1 MHz) or an L38v linear (10-5 MHz) transducer was used for scanning. Requests for POCUS examinations, their findings, and changes in patient management were recorded. Point of care ultrasound examinations were requested and performed in 24 of 814 (3%) outpatient primary care visits. Ten of these studies (42% of POCUS examinations, 1.2% of all patient visits) directed patient management decisions, in each case preventing unnecessary referral. In this austere setting, POCUS proved to be an inexpensive, effective tool at preventing unnecessary referrals. Future medical humanitarian assistance missions may likewise find POCUS to be a primary care force-multiplier.

Return of spontaneous circulation in patients with out-of-hospital cardiac arrest caused by pulmonary embolism using early point-of-care ultrasound and timely thrombolytic agent application: Two case reports

Introduction: Acute pulmonary embolism is a confirmed cause of up to 5% of out-of-hospital cardiac arrest and 5%–13% of unexplained cardiac arrest in patients. However, the true incidence may be much higher, as pulmonary embolism is often clinically underdiagnosed. Thrombolytic therapy is a recognized therapy for pulmonary embolism–associated cardiac arrest but is not routinely recommended during cardiopulmonary resuscitation. Therefore, clinicians should attempt to identify patients with suspected pulmonary embolism. Many point-of care ultrasound protocols suggest diagnosis of pulmonary embolism for cardiac arrest patients. Case presentation: We describe two male patients (60 years and 66 years, respectively) who presented to the emergency department with cardiac arrest within a period of 1 week. With administration of point-of care ultrasound during the ongoing cardiopulmonary resuscitation in both patients, fibrinolytic therapy was initiated under suspicion of cardiac arrest caused by pulmonary embolism. Both patients had return of spontaneous circulation; however, only the second patient, who received fibrinolytic therapy relatively early, was discharged with a good outcome. In this report, we discussed how to diagnose and manage patients with cardiac arrest–associated pulmonary embolism with the help of point-of care ultrasound. We also discuss the different clinical outcomes of the two patients based on the experience of the clinicians and the timing of thrombolytic agent application. Conclusions: If acute pulmonary embolism is suspected in patients with out-of-hospital cardiac arrest, we recommend prompt point-of care ultrasound examination. Point-of care ultrasound may help identify patients with pulmonary embolism during cardiopulmonary resuscitation, leading to immediate treatment, although the clinical outcomes may vary.

Graduating Surgical Residents Lack Competence in Critical Care Ultrasound

Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations. This study was undertaken at the R Adams Cowley Shock Trauma Center, which is a tertiary care center in Baltimore, MD. Graduated general surgery residents were identified at the beginning of their surgical critical care fellowship at our institution, and were included if they participated in our critical care ultrasound education program. Fifteen graduated general surgery residents were included. Prior ultrasound experience ranged from 100% for focused assessment of sonography for trauma (FAST) to 13.3% for advanced cardiac assessment. Self-perceived competence ranged from 46.7% with FAST to 0% for advanced cardiac assessment. Observed competence ranged from 20.0% for FAST examinations to 0% for basic cardiac assessment, advanced cardiac assessment, and inferior vena cava (IVC) assessment. All participants intended to use ultrasound in the future for FAST, pneumothorax detection and basic cardiac assessment, and 86.7% for IVC assessment and advanced cardiac assessment. Of participants with self-perceived competence, 28.6% had observed competence with FAST, 0% with IVC assessment, and 100% with pneumothorax detection. Graduated general surgery residents are not competent in multiple critical care ultrasound examinations despite universally planning to use critical care ultrasound in future practice. Current exposure to ultrasound in residency may give a false sense of competency with ultrasound use. A standardized ultrasound curriculum is an urgent need for general surgery training.

Effect of ultrasound frequency on the Nakagami statistics of human liver tissues.

The analysis of the backscattered statistics using the Nakagami parameter is an emerging ultrasound technique for assessing hepatic steatosis and fibrosis. Previous studies indicated that the echo amplitude distribution of a normal liver follows the Rayleigh distribution (the Nakagami parameter m is close to 1). However, using different frequencies may change the backscattered statistics of normal livers. This study explored the frequency dependence of the backscattered statistics in human livers and then discussed the sources of ultrasound scattering in the liver. A total of 30 healthy participants were enrolled to undergo a standard care ultrasound examination on the liver, which is a natural model containing diffuse and coherent scatterers. The liver of each volunteer was scanned from the right intercostal view to obtain image raw data at different central frequencies ranging from 2 to 3.5 MHz. Phantoms with diffuse scatterers only were also made to perform ultrasound scanning using the same protocol for comparisons with clinical data. The Nakagami parameter–frequency correlation was evaluated using Pearson correlation analysis. The median and interquartile range of the Nakagami parameter obtained from livers was 1.00 (0.98–1.05) for 2 MHz, 0.93 (0.89–0.98) for 2.3 MHz, 0.87 (0.84–0.92) for 2.5 MHz, 0.82 (0.77–0.88) for 3.3 MHz, and 0.81 (0.76–0.88) for 3.5 MHz. The Nakagami parameter decreased with the increasing central frequency (r = −0.67, p < 0.0001). However, the effect of ultrasound frequency on the statistical distribution of the backscattered envelopes was not found in the phantom results (r = −0.147, p = 0.0727). The current results demonstrated that the backscattered statistics of normal livers is frequency-dependent. Moreover, the coherent scatterers may be the primary factor to dominate the frequency dependence of the backscattered statistics in a liver.

Point-of-Care Ultrasound Work Flow Innovation: Impact on Documentation and Billing.

To evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point-of-care US billing compared to ordering US examinations through an electronic medical record. We conducted a retrospective review of point-of-care US billing data (March 2014-February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship. An innovative work flow with the ability to automate US billing and selectively transfer the images and reports for patient care examinations to an electronic medical record and picture archiving and communication system using the QPath US work flow solution (Telexy Healthcare, Maple Ridge, British Columbia, Canada) was implemented. The total number of examinations billed and percent increase in technical and professional revenue, excluding examinations performed by US fellows, before and after implementation of the automated work flow innovation were determined. After implementation of our automated US work flow process, the number of patient care US examinations billed increased significantly due to completing documentation and immediate billing determination at the bedside. The increase in percent billing relative to total examinations was noted in both technical (32% to 61%; P < .0001) and professional (37% to 65%; P < .0001) billing components. In addition, there was a net increase in technical and professional fee revenue to 96% and 78%, respectively. The implementation of an innovative automated work flow to include bedside point-of-care US documentation, order placement, and the automated transfer of images and reports led to a significant increase in US billing revenue, documentation, and compliance.

Teaching Old Dogs New Tricks: A Course for Faculty Learners on Fundamentals of Critical Care Ultrasonography (FoCUS)

SESSION TITLE: Education SESSION TYPE: Original Investigation Slide PRESENTED ON: Tuesday, October 25, 2016 at 02:45 PM - 04:15 PM PURPOSE: Point-of-care ultrasonography has rapidly become a necessary skillset for clinicians caring for critically ill patients. Fellows, residents, and medical students are increasingly being taught how to perform and understand bedside ultrasound (US). Faculty sufficiently competent in critical care ultrasonography to supervise and teach these learners, however, are lacking. Moreover, many faculty feel left behind by the emergence of this modality. We developed a 1-day course specifically tailored to critical care faculty without extensive ultrasound experience in order to develop baseline competence and foster confidence in fundamental critical care ultrasound examinations. METHODS: All faculty learners completed pre- and post-course surveys recording learner characteristics, confidence on a 5-point Likert scale for performing specific US exams and identifying relevant pathology, effectiveness of specific components of the course, and desires for future US training. All faculty learners also completed pre- and post-tests regarding US knowledge and image interpretation. Prerequisite reading materials were provided prior to the course. The course was a combination of didactic lectures (Introduction to US, US for Vascular Access, Lung/Pleural US, Abdominal US, focused TTE, and DVT study) with 5 hours of hands-on small group sessions with expert faculty in our simulation center using standardized patients and task trainers. RESULTS: Eleven critical care faculty learners completed the course. The majority (54%) had ≥15 years of Attending experience, with 64% having had no prior US training. Mean pre-test score was 58±17% and mean post-test score was 73±14% for the group, p=0.006. Faculty learners felt more confident in using ultrasound in performance of procedures and diagnostic examinations after the course (catheter placement, thoracentesis, paracentesis, DVT study, TTE, FAST exam; all p<0.05), and felt more confident in identifying pathology on US after the course (IVC respiratory variation, severe valvular regurgitation, pericardial effusion, hypo/hyper-dynamic left ventricle, loculated pleural effusion, pneumothorax, hydronephrosis, and ascites; all p<0.05). Faculty learners were very interested in future US-based faculty development, especially US for Acute Respiratory Failure and US for Acute Shock. CONCLUSIONS: A 1-day course for critical care faculty with limited ultrasound experience was well received and resulted in tangible improvements in knowledge and image interpretation while increasing confidence performing basic critical care ultrasound examinations/procedures and identifying relevant pathology on ultrasound imaging. CLINICAL IMPLICATIONS: Critical care faculty with limited prior ultrasound experience can learn and improve their ultrasound knowledge, image acquisition, and image interpretation via a short course targeting this learner group. DISCLOSURE: The following authors have nothing to disclose: Deepak Pradhan, Bishoy Zakhary, Vikramjit Mukherjee, Harald Sauthoff No Product/Research Disclosure Information