Emergency Medicine Ultrasonography Subinternship

The Harbor-UCLA Medical Center Department of Emergency Medicine boasts a robust ultrasound program. We have been the home of a competitive ultrasound fellowship since 2002. Our residents are well-trained in ultrasound, completing a required elective as interns and utilizing point-of-care examinations each shift. Our department has several state-of-the-art Sonosite ultrasound machines, including one in each trauma bay.

We have designed this elective in emergency ultrasound to familiarize the fourth-year medical student with point-of-care ultrasound (POCUS) examinations that emergency clinicians frequently utilize. Students will develop the cognitive and manual skills necessary to incorporate bedside ultrasound into their practice. They will be required to complete a minimum of 25 ultrasounds.

Students will attend formal lectures on ultrasound (theory, image acquisition, and interpretation). In addition, they will receive real-time bedside ultrasound teaching. Exams will cover the following areas: cardiac, gallbladder, trauma/FAST, aorta, and transabdominal/endovaginal. Students will be required to keep an ongoing log of their exams, which the course chair will review. Lastly, students will be required to write on a topic in emergency ultrasound by the end of the rotation, which will be under consideration for web publication on emDOCs.net.

Course Objectives

Students will be able to:

1. Demonstrate knowledge of ultrasound physics, technology, and knobology.
2. Outline a strategy for the evaluation of patients with the common indications for ultrasound imaging.
3. Identify specific anatomic landmarks pertaining to emergent bedside ultrasound.
4. Obtain and interpret ultrasound images for the following exams: right upper quadrant, FAS (trauma),obstetric, pericardial fluid, and abdominal aorta.
5. Apply bedside ultrasound for diagnosis and recommend an appropriate definitivestudy for inconclusive ultrasound exams.
6. Use bedside ultrasound for therapeuticprocedures, including paracentesis and central line placement,according to standard Emergency Medicine practice.

Common Diseases/Problems Encountered

1. Undifferentiated abdominal pain
2. Biliary colic
3. Multiple traumas
4. Vaginal bleeding in pregnant patients
5. Pericardial effusion
6. Central and peripheral venous cannulation/access
7. Paracentesis
8. Undifferentiated hypotension
9. Undifferentiated dyspnea

Please review the following before your first day, to ensure you get the most out of your rotation.

Using the Electronic Medical Record System ORCHID (Cerner)

We have made some videos to help you understand how to better navigate the Electronic Medical Record (EMR) we use. We will also train you in person on your orientation day, but you should review the information included beforehand to make your training more useful. Please check this YouTube training video link to get a basic understanding of ORCHID before attending orientation.

Parking

Parking may be limited during your rotation. You may park in any unmarked spot, but please ensure you read all signs. The three-story parking garage (Lot D) only allows visitors to park on the top floor during most hours. You can check in for orientation in the N-14 building on the map and ask for Chanel or Lorie. Here’s the parking map.

Rotation Dates

2024-2025 Academic Year Rotation Dates: 6/17, 7/1, 7/15, 7/29, 8/12, 8/26, 9/9, 9/23, 10/7, 10/21, 11/4, 11/18, 12/2, 1/6, 1/20

Rotations will start on the dates listed. The rotation is typically two weeks in duration. We can make special accommodations on a case-to-case basis inunique circumstances (i.e. three- to four-week rotations).

Applications

You can access applications online via VSLO. Please send an email to Chanel Carter and Lorie Fager, the medical student coordinators, with any specific application-related questions.

Once we accept you for a rotation with us, you also have to meet all the requirements of the Department of Health Services at Los Angeles County for a rotation, which include:

• Health Clearance Packet (E2 Form)
• Background Investigation
• Respiratory Fit Test
• Online Application

You must also complete a Workforce Member form at http://dhs.lacounty.gov/cef. When completing the form:

• Select “New Assignment.”
• The Sponsor Facility is Harbor-UCLA Medical Center.
• The Sponsor Division is Emergency Medicine.
• The Sponsor’s Name is Manpreet Singh.

You can find the required forms and Live Scan fingerprinting on the VSLO website, or we will email them to you upon your rotation approval by our program coordinator, Lorie Fager. Please send an email to the coordinators with any questions about this process.

Lorie Fager

Medical Student Coordinator

[email protected]

Manpreet Singh, MD, MBE, FACEP

Medical Student Clerkship Director

[email protected]