Benjamin F. Byrd III, MD, FASE

Since its enthusiastic adoption as a diagnostic technique, ultrasound has been proven to be safe and effective at diagnosing a wide range of ailments. Since ultrasound brings no risk to the patient, it has been adopted by many specialties as an invaluable tool for patient diagnoses. ASE has been a long-time advocate for cardiovascular ultrasound, and it’s gratifying to see recognition from emergency and critical care physicians, as well as the traditional cardiology practitioner, who are now using it as a vital tool for quality patient care.

ASE’s mission has always been to provide standards, education, research, and training with the goal of optimizing patient care. As we enter an age of increased scrutiny on healthcare costs and patient outcomes, we find ourselves allied with nontraditional partners. In a collaborative effort with our fellow professionals, ASE is increasing its focus on providing tools and resources for emergency department physicians, critical care physicians, primary care physicians, anesthesiologists, and others who are providing care to their patients by using hand-held and portable ultrasound technology at the bedside as an adjunct to the physical examination and traditional echocardiography.

As ultrasound technology continues to develop and machines evolve toward greater miniaturization, hand-held ultrasound machines have become a part of medical care across the globe. ASE set to work with a panel of experts from a variety of fields to determine the best way to engage, assist, and provide education to all users of cardiovascular ultrasound, with a specific focus on focused cardiac ultrasound (FCU) users. This panel met several times throughout the year to help ASE determine the needs of FCU users and how ASE can best provide educational support and services tailored to this group. To facilitate this process, ASE’s first step was to reach out to its current membership community and collect data on the educational needs of those who currently using FCU, those who are helping to train FCU users, and those whose hospital affiliations are currently using FCU in various departments. With over 750 responses received, ASE was able to use your opinions and the expertise of ASE’s panel members to identify several needs of the FCU community that could be addressed by ASE.

Using this survey for its extensive and valuable insights, ASE began developing courses (Focused Cardiac Ultrasound Workshop held in Chicago in November of 2012), offering live scanning sessions (Echo Florida boasts a Point of Care symposium and ASE 2013 in Minneapolis featured hand-held scanning sessions throughout the meeting), and initiating outreach to FCU users and organizations who have a stake in ensuring the successful and appropriate use of FCU. In addition to these efforts, ASE identified two other opportunities to meet the demand for FCU-related tools and resources.

First was a need for training aids to provide case-based and simulation learning that would comprehensively cover the basic image acquisition techniques and appropriate scope of use of FCU. ASE has just completed development of an educational DVD product on FCU that is comprised of the fundamental principles of acquisition and interpretation. The DVD boasts a renowned faculty of FCU and echocardiography experts, including: Kirk Spencer, MD, FASE from the University of Chicago Medical Center; Vicki Noble, MD from Massachusetts General Hospital; Bruce Kimura, MD from Scripps Mercy Hospital; Soni Nilam, MD from the University of Texas; and more. The DVD also boasts state-of-the-art animations of basic heart anatomy and FCU assessment, transducer positioning for lung imaging from the anteroapical and posterolateral basal views, abnormal/normal image comparisons, case studies and more. The imaging menu of the DVD allows for users to navigate the content at their own pace or to use the DVD as a teaching aid for fellows or other practitioners new to FCU.

The DVD will be launched this month at ASE’s 2 ^nd Annual Echo Florida meeting, and later this month, will debut to the American College of Chest Physicians at their Scientific Sessions. As a supporting piece of the FCU educational curriculum, we hope that practitioners from a variety of specialties will take advantage of Echo Florida’s Point of Care Symposium. This one-day symposium includes extensive time for hands-on practice with brief lectures filled with case illustrations and imaging protocols. This session is designed for emergency department and intensive care physicians. Since its initial launch in 2012, the Echo Florida symposium has sold-out and garnered high praise from its attendees.

Second, based upon its research, ASE published a consensus statement in June 2013 as an important step in standardization of patient care and terminology. This document recognizes and distinguishes the important role of FCU as a bedside adjunct to the physical examination. Specific to the adult patient, this statement defines the differences between various cardiovascular ultrasound techniques and provides an overview of equipment, image acquisition, image interpretation, limitations, scope of practice, and considerations for successful use. To accompany the guideline, lead author Kirk Spencer, MD, FASE gave a live ASE Webinar on August 5 that allowed time for questions and answers. This webinar was recorded and is available for on-demand viewing at www.ASEUniversity.org .

As ASE continues forward, collaborating with all users of cardiac ultrasound will remain a high priority for the Society. Consideration is being given to possible future initiatives such as hands-on training programs with documentation of skills (i.e. certificate program), additional guidelines, a “nontraditional users” forum, and partnerships with other Societies to ensure a global uniformity in practice excellence and patient care.