POCUS Training at RLH ACCU – FUSIC-Heart and FUSIC-Lung
Please contact Julia Hadley & Pablo Extremera-Navas for all requests for training
General
We recommend you do not try and undertake FUSIC-Heart and Lung at the same time – do them sequentially.
Realistically, fitting around the craziness of working on ACCU (!), it takes 6-12 months to complete FUSIC-Heart and 3-6 months to complete FUSIC-Lung. In a shorter attachment, partial completion is more realistic – either continuing with training commenced in a previous post or commencing training on ACCU which can then be completed elsewhere in a subsequent post.
The storage capacity of the ultrasound machines is not limitless and periodically we have to delete the oldest scans to make space for new scans. Do not assume that scans will be stored for longer than 3 months so it is a good habit to download your scans to a USB stick (separate instructions available) if you are waiting more than 3 months to get them reviewed (although this should not really happen – see below!). You may also want to save them for future teaching. NB only anonymised images should be downloaded.
Once you have been accredited in either modality for more than 12 months, you can apply to be a mentor – this is great for maintaining your skills, supporting your colleagues and will be invaluable as a consultant!
Monthly cross-site FUSIC-Heart Education and Governance meeting (RLH, SBH, NUH, WXH)
Soon to incorporate lung ultrasound!
Third Thursday of each month at 14:00, held on Teams. Details circulated by e-mail and WhatsApp during week before. Teaching session, case presentations and discussion. The meetings are recorded and can be accessed via the Teams Chat if you want to catch up on teaching sessions you have missed.
We strongly encourage you to participate in these meetings to supplement your practical learning. They are an excellent learning opportunity for all levels of practitioners.
The responsibility for case presentations rotates between sites, with each site presenting a case approximately 4 times per year. We expect one of the trainees being mentored FUSIC Heart / Lung training to present when it falls to RLH.
WhatsApp Group
We have a WhatsApp group for POCUS training, including mentors and trainees. Please provide your mobile number once accepted for FUSIC Heart or Lung training.
We use this for:
Arranging mentor sessions (mentors can offer their availability and trainees can similarly make requests according to their availability).
Publicising monthly education meetings and other training opportunities.
Sharing details of ‘good’ patients to scan – no personal identifiable information please. Also do not give away the findings! (eg. ‘There is a good patient to echo in bed 42, initials MA’)
FICE / FUSIC Heart
(Referred to as FICE for simplicity)
Accredited FICE Mentor Group:
Julia Hadley (ACCU Consultant)
Pablo Extremera-Navas (ACCU Consultant)
Brigitta Fazzini (ACCP)
*Jon MacKenney (ACCU Consultant)
Toby Reynolds (Anaesthetic Consultant)
*Lynne Barrass (ACCU Consultant)
*PJ Zolfaghari (ACCU Consultant)
*Zudin Puthucheary (ACCU Consultant)
Malgorzata Starczewska (ACCU Consultant)
Jack Samuel (ACCU locum consultant)
(note: some trainees and clinical fellows may also be accredited mentors)
* Due to other work commitments, Zudin, Lynne, Jon and PJ are unable to offer dedicated mentored sessions but are happy to supervise scanning when they are on clinical duty on ACCU.
We do not allocate trainees to individual mentors but share the workload between us all – so you can scan with several different mentors during your time with us. This is quite beneficial as each mentor will have different tips and tricks!
BSE-accredited FICE Supervisors:
Dr Stephen Shepherd, Dr Segun Olusanya, Dr Hazem Lashim, Dr Rosalba Spiritoso
-Consultants in Intensive Care at Barts
Structure of FICE training at RLH ACCU and Progress Expectations
Prior to commencing supervised scanning you must have registered with the ICS for FUSIC-Heart and undertaken EITHER a face-to-face course OR their on-line learning.
In recent years there have been increasing numbers of consultants, trainees, clinical fellows and advanced clinical practitioners wanting to undertake FICE accreditation. Getting through the whole logbook of supervised scans and reviewing unsupervised recorded scans takes many hours of mentor time. We have a finite mentor resource, which struggles to meet the demand. We endeavour to support all requests for FICE mentorship from anyone working on the ACCU (and, only if capacity allows, will extend this to trainees outside the ACCU). In the event that we are significantly oversubscribed, then priority is given to ICM trainees / senior ICM clinical fellows. In order to extend this training opportunity to as many individuals as possible, we are trying to maximise the efficiency of the mentorship system:
In our experience, a lot of people ‘sign up’ and commence their logbooks but never complete them, for a variety of reasons – it is, indeed, a significant undertaking which requires a lot of time and commitment on behalf of the individual. But those who take up one or two, often very spaced out, mentor sessions without doing much scanning in between or making significant progress towards completion of their logbooks dilute our valuable mentor resource, making it harder for everyone to achieve accreditation.
We recognise that there are many competing demands on everyone’s time and progress will probably not be linear due to rotas, leave, non-work commitments etc. However we propose the following minimum rate of progress in order to be allowed to continue in the RLH FICE program:
Once the candidate has registered with the ICS for FUSIC-Heart, attended a course (face-to-face or virtual) and signed up to the RLH ACCU FICE program, the mentor group will commit to offering 2-3 mentored sessions within the first 6 weeks. The goal of these sessions will be to directly supervise scans to achieve a level of competence allowing independent scanning to be commenced. This may well be before completion of all 10 supervised scans. Once unsupervised scanning has commenced, the candidate should record 5-10 scans for review between mentor sessions and should progress their logbook at a minimum rate of 12 scans every 2 months. Mentor sessions can be a combination of supervised scanning and review of recorded scans.
Complete a FICE report form for each of your recorded scans and note on the form which machine you have recorded the scan on (as we have several in use!) Please arrive at supervised sessions with your logbook and some blank FICE Logbook Reporting forms. Please ensure that there is no patient identifiable data in your logbook.
Nomenclature of recorded scans:
Please save scans under the patient’s name and hospital number as a minimum. You can add a comment in the notes section that it is a FICE logbook scan and your initials, if you wish.
Downloading anonymised scans to USB stick:
This is possible and there is a ‘how to’ guide available separately in the shared folder
(ACCU > Trainees > POCUS)
A note on echo findings:
If you encounter unexpected pathology during echo practice, please inform the ACCU consultant responsible for the patient’s care and recommend that a formal echo is requested.
If you identify any patients with interesting echo findings, please share this on the FICE WhatsApp group with patient initials and bed-space (but not the echo findings!) so that they can take the opportunity to perform a practice echo themselves.
FUSIC Lung
Accredited FUSIC-Lung Mentor Group:
Pablo Extremera-Navas (ACCU Consultant)
Brigitta Fazzini (ACCP)
Zudin Puthucheary (ACCU Consultant)
Musie Tsehaye (Physiotherapist)
Final Assessors
Pablo Extremera-Navas (ACCU Consultant)
Brigitta Fazzini (ACCP)
Zudin Puthucheary (ACCU Consultant)
Prior to commencing supervised scanning you must have registered with the ICS for FUSIC-Lung and undertaken EITHER a face-to-face course OR their on-line learning.
You need a minimum of 10 supervised scans and a total logbook of 30. In our experience the majority of level 3 patients have findings on lung ultrasound.