Echo / IVC Curriculum

US Didactics and scan shifts:

Week 1 – Echo – the views – SX, PSL, PSS, AP4 and pathology that can be identifed with each-

Week 2 – Echo – semi-quantitative assessment of function/contractility/heart failure (- EPSS, fractional shortening, VTI (diastology) – ) and review of cardiac standstill –

Week 3 – the IVC and fluid tolerance –

Week 4 – Case-based presentations by Faculty, and Fellows present and review Echo/IVC studies –

Reading/Review List:

SonoGuide: Cardiac

SonoSpot: TutorialEcho CasesIVC CasesEcho and IVC StudiesTips & Tricks

Podcast: Soundbytes: Echo and RUSH protocolEMCrit for IVC and Fluid Tolerance and RUSH;

Ultrasound Podcast on Interview with Scott Weingart on RUSH and Part 2 of the Interview , on Echo, Diastology How-To, and Part 1 and Part 2, Integrated IVC with Canada study, and Cardiac valves   , Scott Weigart on IVC ultrasound and Carotid VTI for fluid responsiveness and Fluids in Sepsis with Bedside Echo Assessment and Pericardial Tamponade and Pericardial tamponade Part 2, Haney Mallemat on Art and science of Fluid responsiveness

ICN Network: Echo the SX view and IVC Basics;

AIUM Ultrasound First: Caval Sonography in Shock

WINFOCUS International Consensus Statement on Focused Cardiac Echo

International evidence-based recommendations for focused cardiac ultrasound


Ma/Mateer/Blaivas Chapters:

6. Cardiac, Robert F. Reardon and Scott A. Joing


Dawson/Mallin iBook Chapters:

Volume 1, Chapter 2 – Basic Echo

Volume 1, Chapter 5 – RUSH

Volume 2, – Advanced Echo, Diastology

Volume 1, Chapter 12 – Fluid responsiveness

Echo Studies: PubMed Collection

IVC Studies: Pubmed Collection


Echo Studies:

Breitkreutz R, Walcher F, Seeger FH. Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm. Crit Care Med 2007;15(Suppl 5):S150-S161

Gunst M, Ghaemmaghami V, Sperry J, et al. Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care. J Trauma 2008 Sep;65(3):509-516

Gunst M, Sperry J, Ghaemmaghami V, O’Keeffe T, Friese R, Frankel H Bedside echocardiographic assessment for trauma/critical care: the BEAT exam. J Am Coll Surg. 2008 Sep;207(3):e1-3. doi: 10.1016/j.jamcollsurg.2008.05.027. Epub 2008 Jul 21. No abstract available

Jones AE, Tayal VS, Sullivan DM, Kline JA. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med 2004;32:1703-1708.

Jones AE, Tayal VS, Kline JA. Focused training of emergency medicine residents in goal-directed echocardiography: a prospective study. Acad Emerg Med 2003;10:1054-1058

Kasper W , Konstantinides S, Geibel A.  Prognostic significance of right ventricular afterload stress detected via cardiac ultrasound in patients with clinically suspected pulmonary embolism.  Heart 1997;77:346-9.

Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Smadar K, Porter TR, Spencer KT, Tayal V, Wei K.  Focused Cardiac Ultrasound in the Clinical Setting: A consensus statement of the American Society for Echocardiography and the American College of Emergency Physicians.  J Am Soc Echo  2010;23(12):1225-30   CrossRef,  Web of Science® Times Cited: 3

Moore CL, Rose GA, Tayal VS, Sullivan DM, Arrowood JA, Kline JA. Determination of left ventricular function by emergency physician echocardiography of hypotensive patients. Acad Emerg Med 2002;9:186-193

Moore, C. Current issues with emergency cardiac ultrasound probe and image conventionsAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine 15, 278-84 (2008).

Rose JS, Bair AE, Mandavia D, Kinser DJ. The UHP protocol: a novel ultrasound approach to the empiric evaluation of the undifferentiated hypotensive patient. Am J Emerg Med 2001;19:299-302.

Tayal VS, Kline JA. Emergency echocardiography to detect pericardial effusion in patients in PEA and near-PEA states. Resuscitation 2003;59:315-318.

Taylor RA, Davis J, Liu R, Gupta V, Dziura J, Moore CL Point-of-Care Focused Cardiac Ultrasound for Prediction of Pulmonary Embolism Adverse Outcomes.J Emerg Med. 2013 Jul 1. doi:pii: S0736-4679(13)00450-2. 10.1016/j.jemermed.2013.04.014

Lo A, Stewart P, Younger JF, Atherton J, Prasad SB. Usefulness of right ventricular myocardial strain in assessment of response to thrombolytic therapy in acute pulmonary embolism. Eur J Echocardiogr. 2010 Dec;11(10):892-5. doi: 10.1093/ejechocard/jeq091. Epub 2010 Sep 6.

Ünlüer EE, Senturk GÖ, Karagöz A, Uyar Y, Bayata S. Red flag in bedside echocardiography for acute pulmonary embolism: remembering McConnell’s sign. Am J Emerg Med. 2013 Apr;31(4):719-21. doi: 10.1016/j.ajem.2012.12.007. Epub 2013 Feb 8.

McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996;78:469-73.

Goldhaber SZ. Echocardiography in the management of pulmonary embolism.Ann Intern Med. 2002 May 7;136(9):691-700.

Casazza F1Bongarzoni ACapozi AAgostoni ORegional right ventricular dysfunction in acute pulmonary embolism and right ventricular infarction. Eur J Echocardiogr. 2005 Jan;6(1):11-4.

Hoffmann B, Gullett JP. Bedside transthoracic sonography in suspected pulmonary embolism: a new tool for emergency physicians. Acad Emerg Med. 2010 Sep;17(9):e88-93. doi: 10.1111/j.1553-2712.2010.00831.x. No abstract available.

Blaivas M, Fox JC Outcome in cardiac arrest patients found to have cardiac standstill on the bedside emergency department echocardiogram. Acad Emerg Med. 2001 Jun;8(6):616-21

Salen P, Melniker L, Chooljian C, Rose JS, Alteveer J, Reed J, Heller M  Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients? Am J Emerg Med. 2005 Jul;23(4):459-62

Blyth L, Atkinson P, Gadd K, Lang E  Bedside focused echocardiography as predictor of survival in cardiac arrest patients: a systematic review. Acad Emerg Med. 2012 Oct;19(10):1119-26. doi: 10.1111/j.1553-2712.2012.01456.x. Epub 2012 Oct 5. Review

Seif D, Meeks A, Mailhot T, Perera P. Emergency department diagnosis of infective endocarditis using bedside emergency ultrasound. Crit Ultrasound J. 2013 Feb 11;5(1):1. doi: 10.1186/2036-7902-5-1

Goodman A, Perera P, Mailhot T, Mandavia D. The role of bedside ultrasound in the diagnosis of pericardial effusion and cardiac tamponade. J Emerg Trauma Shock. 2012 Jan;5(1):72-5. doi: 10.4103/0974-2700.93118

Controversial: Spencer et al. Focused Cardiac Ultrasound. Recommendations by the American Society of Echocardiography. JASE June 2013

IVC Studies:

Anderson KL, Jenq KY, Fields JM, Panebianco NL, Dean AJ. Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lungultrasonography. Am J Emerg Med. 2013 Jun 12. doi:pii: S0735-6757(13)00282-9. 10.1016/j.ajem.2013.05.007.

Lyon M, Blaivas M, Brannam L Sonographic measurement of the inferior vena cava as a marker of blood loss. Am J Emerg Med. 2005 Jan;23(1):45-50

Brennan JM, Ronan A, Goonewardena S, Blair JE, Hammes M, Shah D, Vasaiwala S, Kirkpatrick JN, Spencer KT  Handcarried ultrasound measurement of the inferior vena cava for assessment of intravascular volume status in the outpatient hemodialysis clinic. Clin J Am Soc Nephrol. 2006 Jul;1(4):749-53. Epub 2006 May 24

Stawicki SP, Braslow BM, Panebianco NL, Kirkpatrick JN, Gracias VH, Hayden GE, Dean AJ  Intensivist use of hand-carried ultrasonography to measure IVC collapsibility in estimating intravascular volume status: correlations with CVP. J Am Coll Surg. 2009 Jul;209(1):55-61. doi: 10.1016/j.jamcollsurg.2009.02.062. Epub 2009 May 1

Blehar DJ, Dickman E, Gaspari R.Identification of congestive heart failure via respiratory variation of inferior vena cava diameter. Am J Emerg Med. 2009 Jan;27(1):71-5. doi: 10.1016/j.ajem.2008.01.002.

Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med. 2010 Mar;55(3):290-5. doi: 10.1016/j.annemergmed.2009.04.021. Epub 2009 Jun 25.

Ng L, Khine H, Taragin BH, Avner JR, Ushay M, Nunez D. Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children?Pediatr Emerg Care. 2013 Mar;29(3):337-41. doi: 10.1097/PEC.0b013e31828512a5.

Wallace DJ, Allison M, Stone MB. Inferior vena cava percentage collapse during respiration is affected by the sampling location: an ultrasound study in healthy volunteers. Acad Emerg Med. 2010 Jan;17(1):96-9. doi: 10.1111/j.1553-2712.2009.00627.x. Epub 2009 Dec 9

Ferrada P, Vanguri P, Anand RJ, Whelan J, Duane T, Wolfe L, Ivatury R Flat inferior vena cava: indicator of poor prognosis in trauma and acute care surgery patients. Am Surg. 2012 Dec;78(12):1396-8

Haines EJ, Chiricolo GC, Aralica K, Briggs WM, Van Amerongen R, Laudenbach A, O’Rourke K, Melniker L. Derivation of a pediatric growth curve for inferior vena caval diameter in healthy pediatric patients: brief report of initial curve development. Crit Ultrasound J. 2012 May 28;4(1):12. doi: 10.1186/2036-7902-4-12

Chen L, Kim Y, Santucci KA.Use of ultrasound measurement of the inferior vena cava diameter as an objective tool in the assessment of children with clinical dehydration. Acad Emerg Med. 2007 Oct;14(10):841-5

Lanspa MJGrissom CKHirshberg ELJones JPBrown SM. Applying dynamic parameters to predict hemodynamic response to volume expansion in spontaneously breathing patients with septic shock. Shock. 2013 Feb;39(2):155-60. doi: 10.1097/SHK.0b013e31827f1c6a.

Laurent Muller, Xavier Bobbia, […], and the AzuRea group. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use; Crit Care. 2012; 16(5): R188

THE RUSH PROTOCOL Part 1 and Part 2
 protocol – Lichtenstein

EGLS – Echo-Guided Life Support and the Ultrasound Podcast on EGLS

Volpicelli and Shock  – Multi-organ assessment

CAUSE Study: cardiac arrest ultrasound



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