Empfehlungen zur Ultraschallausbildung in der internistischen Intensiv- und Notfallmedizin: Positionspapier der DGIIN, DEGUM und DGK

  • G. Michels
  • H. Zinke
  • M. Möckel
  • D. Hempel
  • C. Busche
  • U. Janssens
  • S. Kluge
  • R. Riessen
  • M. Buerke
  • M. Kelm
  • R. S. von Bardeleben
  • F. Knebel
  • H.-J. Busch
Positionspapier
  • 227 Downloads

Zusammenfassung

Die Point-of-care-Sonographie bildet in der Akutmedizin die Voraussetzung in der Diagnostik und Therapiesteuerung von kritisch kranken Patienten. Bisher existiert kein einheitliches Ausbildungskonzept für die internistische Intensiv- und Notfallmedizin. Im Rahmen eines Basislevels erfährt der Auszubildende eine grundlegende theoretische und klinisch-praktische Ultraschallausbildung sowohl in der Abdomen- und Thoraxsonographie als auch in der fokussierten kardiovaskulären Sonographie. In einem 2. Schritt können spezielle Kenntnisse auf Expertenniveau erworben werden. Dieses 2‑stufige Ausbildungskonzept dient der Qualitätssicherung in der Sonographie in der internistischen Intensiv- und Notfallmedizin.

Schlüsselwörter

Notfallmedizin Intensivmedizin Sonographie Ausbildung Fokussierter Untersuchungsgang 

Recommendations for education in ultrasound in medical intensive care and emergency medicine: position paper of DGIIN, DEGUM and DGK

Abstract

Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine.

Keywords

Emergency medicine Intensive care medicine Ultrasound Training Focussed examination 

Literatur

  1. 1.
    Kirkpatrick AW, Sirois M, Laupland KB et al (2004) Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma 57:288–295CrossRefPubMedGoogle Scholar
  2. 2.
    Dorman T, Angood PB, Angus DC et al (2004) Guidelines for critical care medicine training and continuing medical education. Crit Care Med 32:263–272CrossRefPubMedGoogle Scholar
  3. 3.
    Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 1. Chest 128:881–895CrossRefPubMedGoogle Scholar
  4. 4.
    Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 2. Chest 128:1766–1781CrossRefPubMedGoogle Scholar
  5. 5.
    Michels G, Breitkreutz R, Pfister R (2014) Value of lung ultrasound in emergency and intensive care medicine. Dtsch Med Wochenschr 139(45):2301–2307CrossRefPubMedGoogle Scholar
  6. 6.
    Moore CL, Copel JA (2011) Current concepts point-of-care ultrasonography. N Engl J Med 364:749–757CrossRefPubMedGoogle Scholar
  7. 7.
    Frankel HL, Kirkpatrick AW, Elbarbary M et al (2015) Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients. Part I: general ultrasonography. Crit Care Med 43(11):2479–2502CrossRefPubMedGoogle Scholar
  8. 8.
    Brown SM, Kasal J (2015) Bedside ultrasound in the intensive care unit: Where is the evidence? Semin Respir Crit Care Med 36(6):878–889CrossRefPubMedGoogle Scholar
  9. 9.
    Levitov A, Frankel HL, Blaivas M (2016) Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients. Part II: cardiac ultrasonography. Crit Care Med 44(6):1206–1227CrossRefPubMedGoogle Scholar
  10. 10.
    Chelly J, Deye N, Guichard JP et al (2016) The optic nerve sheath diameter as a useful tool for early prediction of outcome after cardiac arrest: a prospective pilot study. Resuscitation 103:7–13CrossRefPubMedGoogle Scholar
  11. 11.
    Gobatto AL, Besen BA, Tierno PF (2016) Ultrasound-guided percutaneous dilational tracheostomy versus bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients (TRACHUS): a randomized noninferiority controlled trial. Intensive Care Med 42(3):342–351CrossRefPubMedGoogle Scholar
  12. 12.
    Whitson MR, Mayo PH (2016) Ultrasonography in the emergency department. Crit Care 20(1):227. doi:10.1186/s13054-016-1399-x CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Breitkreutz R, Campo dell’ Orto M, Hamm C et al (2013) Does the integration of personalized ultrasound change patient management in critical care medicine? Observational trials. Emerg Med Int. doi:10.1155/2013/946059 Google Scholar
  14. 14.
    Wang X, Liu D, He H et al (2015) Using critical care chest ultrasonic examination in emergency consultation: a pilot study. Ultrasound Med Biol 41(2):401–406CrossRefPubMedGoogle Scholar
  15. 15.
    Dietrich CF, Goudie A, Chiorean L (2016) Point of care ultrasound: a WFUMB position paper. Ultrasound Med Biol 43(1):49–58. doi:10.1016/j.ultrasmedbio.2016.06.021 CrossRefPubMedGoogle Scholar
  16. 16.
    Neri L, Storti E, Lichtenstein D (2007) Toward an ultrasound curriculum for critical care medicine. Crit Care Med 35(5 Suppl):S290–S304CrossRefPubMedGoogle Scholar
  17. 17.
    Hagendorff A, Tiemann K, Simonis G et al (2013) Empfehlungen zur Notfallechokardiographie. Kardiologe 8:45–64CrossRefGoogle Scholar
  18. 18.
    Neskovic AN, Hagendorff A, Lancellotti P et al (2013) Emergency echocardiography – the European Association of Cardiovascular Imaging recommendations. Eur Heart J Cardiovasc Imaging 14:1–11CrossRefPubMedGoogle Scholar
  19. 19.
    Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 37:2129–2200CrossRefPubMedGoogle Scholar
  20. 20.
    Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–271CrossRefPubMedGoogle Scholar
  21. 21.
    Volpicelli G, Elbarbary M, Blaivas M et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38(4):577–591CrossRefPubMedGoogle Scholar
  22. 22.
    Via G, Hussain A, Wells M et al (2014) International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr 27(7):683.e1–683.e33CrossRefGoogle Scholar
  23. 23.
    Ayuela Azcárate JM, Clau-Terre F, Vicho Pereira R et al (2014) Consensus document on ultrasound training in Intensive Care Medicine. Care process, use of the technique and acquisition of professional skills. Med Intensiva 38:33–40CrossRefPubMedGoogle Scholar
  24. 24.
    Expert Round Table on Echocardiography in ICU (2014) International consensus statement on training standards for advanced critical care echocardiography. Intensive Care Med 40:654–666CrossRefGoogle Scholar
  25. 25.
    Expert Round Table on Ultrasound in ICU (2011) International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37(7):1077–1083CrossRefGoogle Scholar
  26. 26.
    Tonner PH, Bein B, Breitkreutz R et al (2011) DGAI-certified seminar series: anaesthesia focussed echocardiography: module 4 cardiosonography. Anasthesiol Intensivmed Notfallmed Schmerzther 46(11–12):766–770PubMedGoogle Scholar
  27. 27.
    Trautner H, Markus CK, Steinhübel B et al (2011) The DGAI training module 2 in anaesthetic focussed sonography: vascular sonography. Anasthesiol Intensivmed Notfallmed Schmerzther 46(11–12):756–759PubMedGoogle Scholar
  28. 28.
    Casaroto E (2015) Bedside echocardiography in critically ill patients. Einstein (Sao Paulo) 13(4):644–646CrossRefGoogle Scholar
  29. 29.
    Kameda T, Taniguchi N (2016) Overview of point-of-care abdominal ultrasound in emergency and critical care. J Intensive Care 4:53CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hempel D, Pfister R, Michels G (2016) Hemodynamic monitoring in intensive care and emergency medicine: integration of clinical signs and ultrasound findings. Med Klin Intensivmed Notfmed 111(7):596–604CrossRefPubMedGoogle Scholar
  31. 31.
    Werdan K, Ruß M, Buerke M et al (2012) Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German-Austrian S3 guideline. Dtsch Arztebl Int 109(19):343–351PubMedPubMedCentralGoogle Scholar
  32. 32.
    Dellinger RP, Levy MM, Rhodes A et al (2013) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 39(2):165–228CrossRefPubMedGoogle Scholar
  33. 33.
    Konstantinides SV, Torbicki A, Agnelli G et al (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35(43):3033–3069CrossRefPubMedGoogle Scholar
  34. 34.
    Galiè N, Humbert M, Vachiery JL et al (2016) 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119CrossRefPubMedGoogle Scholar
  35. 35.
    Janssens U, Jung C, Hennersdorf M et al (2016) Empfehlungen zum hämodynamischen Monitoring in der internistischen Intensivmedizin. Kardiologe 10:149–169CrossRefGoogle Scholar
  36. 36.
    Kanji HD, McCallum JL, Bhagirath KM et al (2016) Curriculum development and evaluation of a hemodynamic critical care ultrasound: a systematic review of the literature. Crit Care Med 44(8):e742–750CrossRefPubMedGoogle Scholar
  37. 37.
    Blumhof S, Wheeler D, Thomas K et al (2016) Change in diaphragmatic thickness during the respiratory cycle predicts extubation success at various levels of pressure support ventilation. Lung 194(4):519–525CrossRefPubMedGoogle Scholar
  38. 38.
    Mayo P, Volpicelli G, Lerolle N et al (2016) Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung. Intensive Care Med 42(7):1107–1117CrossRefPubMedGoogle Scholar
  39. 39.
    Schönhofer B, Geiseler J, Dellweg D et al (2014) Prolonged weaning: S2k-guideline published by the German Respiratory Society. Pneumologie 68:19–75CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • G. Michels
    • 1
  • H. Zinke
    • 2
  • M. Möckel
    • 3
  • D. Hempel
    • 4
  • C. Busche
    • 5
  • U. Janssens
    • 6
  • S. Kluge
    • 7
  • R. Riessen
    • 8
  • M. Buerke
    • 9
  • M. Kelm
    • 10
  • R. S. von Bardeleben
    • 11
  • F. Knebel
    • 12
  • H.-J. Busch
    • 5
  1. 1.Klinik III für Innere MedizinUniversität zu KölnKölnDeutschland
  2. 2.Klinik für konservative IntensivmedizinDietrich-Bonhoeffer-KlinikumNeubrandenburgDeutschland
  3. 3.Notfallmedizin der CharitéCampus Virchow-Klinikum, Universitätsmedizin BerlinBerlinDeutschland
  4. 4.Klinik für Innere Medizin IVUniversitätsklinikum JenaJenaDeutschland
  5. 5.Universitäts-NotfallzentrumUniversitätsklinikum FreiburgFreiburgDeutschland
  6. 6.Klinik für Innere Medizin und IntensivmedizinSt.-Antonius-HospitalEschweilerDeutschland
  7. 7.Klinik für IntensivmedizinUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland
  8. 8.Department für Innere Medizin, Internistische IntensivstationUniversitätsklinikum TübingenTübingenDeutschland
  9. 9.Klinik für Kardiologie, Angiologie und internistische IntensivmedizinSt. Marien-Krankenhaus Siegen gem. GmbHSiegenDeutschland
  10. 10.Klinik für Kardiologie, Pneumologie und AngiologieUniversitätsklinikum DüsseldorfDüsseldorfDeutschland
  11. 11.Kardiologie IUniversitätsmedizin der Johannes-Gutenberg-Universität MainzMainzDeutschland
  12. 12.Medizinische Klinik mit Schwerpunkt Kardiologie und AngiologieCharité – Universitätsmedizin BerlinBerlinDeutschland

Personalised recommendations