床边护理点超声(POCUS)越来越多地用于评估医疗患者。目前,对于什么POCUS课程适合内科住院医师培训计划,尚无共识。本文件详细介绍了加拿大内科超声(CIMUS)小组基于共识的建议,由39名成员组成,代表加拿大的14个机构。事先确定了选择课程内容的指导原则。共识被定义为至少80%的成员同意POCUS申请,认为适合于核心(内科研究生课程[PGY]1-3)和扩展(一般内科PGY4-5)培训计划的学员的教学和评估。我们建议为PGY1-3核心课程(下腔静脉,肺B线,胸腔积液,和腹腔游离液)和三个超声引导程序(中心静脉导管插入术,胸腔穿刺术,和穿刺)。对于扩展的PGY4-5课程,我们建议另外七种应用(颈内静脉,肺巩固,气胸,膝关节积液,左心室总收缩功能,心包积液,和右心室应变)和四个超声引导程序(膝关节穿刺术,动脉线插入,动脉血气采样,和外周静脉导管插入术)。这些建议将为国家一级的培训方案提供一个框架。
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no
consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the
consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori.
Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.