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      Recommendations for core critical care ultrasound competencies as a part of specialist training in multidisciplinary intensive care: a framework proposed by the European Society of Intensive Care Medicine (ESICM)

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          Abstract

          Abstract

          Critical care ultrasound (CCUS) is an essential component of intensive care practice. Although existing international guidelines have focused on training principles and determining competency in CCUS, few countries have managed to operationalize this guidance into an accessible, well-structured programme for clinicians training in multidisciplinary intensive care. We seek to update and reaffirm appropriate CCUS scope so that it may be integrated into the international Competency-based Training in Intensive Care Medicine. The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described. Importantly, we discuss the rationale for inclusion but also exclusion of competencies listed.

          Background/aim

          Critical care ultrasound (CCUS) is an essential component of intensive care practice. The purpose of this consensus document is to determine those CCUS competencies that should be a mandatory part of training in multidisciplinary intensive care.

          Methods

          A three-round Delphi method followed by face-to-face meeting among 32 CCUS experts nominated by the European Society of Intensive Care Medicine. Agreement of at least 90% of experts was needed in order to enlist a competency as mandatory.

          Results

          The final list of competencies includes 15 echocardiographic, 5 thoracic, 4 abdominal, deep vein thrombosis diagnosis and central venous access aid.

          Conclusion

          The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described.

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          Most cited references4

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          American College of Chest Physicians/La Société de Réanimation de Langue Française statement on competence in critical care ultrasonography.

          To define competence in critical care ultrasonography (CCUS). The statement is sponsored by the Critical Care NetWork of the American College of Chest Physicians (ACCP) in partnership with La Société de Réanimation de Langue Française (SRLF). The ACCP and the SRLF selected a panel of experts to review the field of CCUS and to develop a consensus statement on competence in CCUS. CCUS may be divided into general CCUS (thoracic, abdominal, and vascular), and echocardiography (basic and advanced). For each component part, the panel defined the specific skills that the intensivist should have to be competent in that aspect of CCUS. In defining a reasonable minimum standard for CCUS, the statement serves as a guide for the intensivist to follow in achieving proficiency in the field.
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            International expert statement on training standards for critical care ultrasonography.

            (2011)
            Training in ultrasound techniques for intensive care medicine physicians should aim at achieving competencies in three main areas: (1) general critical care ultrasound (GCCUS), (2) "basic" critical care echocardiography (CCE), and (3) advanced CCE. A group of 29 experts representing the European Society of Intensive Care Medicine (ESICM) and 11 other critical care societies worldwide worked on a potential framework for organizing training adapted to each area of competence. This framework is mainly aimed at defining minimal requirements but is by no means rigid or restrictive: each training organization can be adapted according to resources available. There was 100% agreement among the participants that general critical care ultrasound and "basic" critical care echocardiography should be mandatory in the curriculum of intensive care unit (ICU) physicians. It is the role of each critical care society to support the implementation of training in GCCUS and basic CCE in its own country.
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              Critical Care Ultrasound

              Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training program. The aim of this review was to assess the similarities and differences among these postgraduate intensive care/critical care training program.
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                Author and article information

                Contributors
                avkwong@mac.com
                Journal
                Crit Care
                Critical Care
                BioMed Central (London )
                1364-8535
                1466-609X
                3 July 2020
                3 July 2020
                2020
                : 24
                : 393
                Affiliations
                [1 ]GRID grid.489664.1, ISNI 0000 0001 1034 0437, European Society of Intensive Care Medicine, ; Brussels, Belgium
                [2 ]GRID grid.46699.34, ISNI 0000 0004 0391 9020, Department of Critical Care, , King’s College Hospital, ; London, UK
                [3 ]GRID grid.470634.2, Department of Intensive Care, , Hospital General Universitario de Castellon, ; Castellon de la Plana, Spain
                [4 ]GRID grid.416224.7, ISNI 0000 0004 0417 0648, Department of Intensive Care, , Royal Surrey County Hospital, ; Guildford, UK
                [5 ]GRID grid.4989.c, ISNI 0000 0001 2348 0746, Department of Intensive Care, , CHIREC Hospitals, Université Libre de Bruxelles, ; Brussels, Belgium
                [6 ]GRID grid.134996.0, ISNI 0000 0004 0593 702X, Medical Intensive Care, , DRIME department in University Hospital of Amiens, ; Amiens, France
                [7 ]GRID grid.414093.b, Service d’Anesthésie-Réanimation, Hôspital Européen Georges Pompidou, AP-HP, ; Paris, France
                [8 ]GRID grid.416477.7, ISNI 0000 0001 2168 3646, Division of Pulmonary, Critical Care, and Sleep Medicine, Northshore/Long Island Jewish Medical Centers, , Northwell Health, ; New Hyde Park, NY USA
                [9 ]GRID grid.1013.3, ISNI 0000 0004 1936 834X, Department of Intensive Care Medicine, Nepean Hospital, , University of Sydney, ; Sydney, Australia
                [10 ]GRID grid.413756.2, ISNI 0000 0000 9982 5352, Unit of Medical-Surgical Intensive Care, , Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, ; Boulogne-Billancourt, France
                [11 ]Medical Intensive Care Unit, Hospital Ambroise-Paré (AP-HP), Boulogne (Paris-Ouest university), Boulogne-Billancourt, France
                [12 ]GRID grid.415081.9, ISNI 0000 0004 0493 6869, Department of Emergency Medicine, , San Luigi Gonzaga University Hospital, ; Orbassano, Torino, Italy
                [13 ]GRID grid.39381.30, ISNI 0000 0004 1936 8884, Division of Critical Care, Department of Medicine, , Western University London, ; Ontario, Canada
                [14 ]GRID grid.416409.e, ISNI 0000 0004 0617 8280, St James’s Hospital, Multidisciplinary Intensive Care Research Organization (MICRO), ; Dublin, Ireland
                [15 ]GRID grid.4491.8, ISNI 0000 0004 1937 116X, Department of Anaesthesia and Intensive Care, , Charles University, Third Faculty of Medicine and FNKV University Hospital in Prague, ; Prague, Czech Republic
                Author information
                http://orcid.org/0000-0003-4968-7328
                Article
                3099
                10.1186/s13054-020-03099-8
                7333303
                32620166
                3ca88af3-adf8-4d61-96d5-3b6073408c7a
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 4 May 2020
                : 17 June 2020
                Categories
                Review
                Custom metadata
                © The Author(s) 2020

                Emergency medicine & Trauma
                core critical care ultrasound,specialist training,competencies,education in intensive care

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