Zusammenfassung
Die strukturierte Ultraschallausbildung in der internistischen Intensiv- und Notfallmedizin (SIN) basiert auf einem 2‑Stufen-Konzept, das von den 3 nationalen Fachgesellschaften Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin e. V. (DGIIN), Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. (DGK) und Deutsche Gesellschaft für Ultraschall in der Medizin e. V. (DEGUM) vertreten wird. Das Konzept umfasst ein Basislevel (SIN-I) und ein Expertenlevel (SIN-II), die aufeinander aufbauend mithilfe moderner Lehrmethoden leitsymptomorientierte Sonographie für die Notfall- und Intensivmedizin vermitteln. Es werden sowohl theoretische Kenntnisse wie auch praktische Fertigkeiten gelehrt und im Rahmen einer Prüfung kontrolliert. Ziel ist es, die in nationalen und internationalen Leitlinien empfohlenen Vorgaben zum Einsatz der Sonographie in der Notfall- und Intensivmedizin in der klinischen Praxis standardisiert zu etablieren.
Abstract
Structured sonography training in internal medicine intensive care and emergency medicine (SIN) comprises two levels and was proposed by three national societies in Germany (DGIIN, DGK and DEGUM). The curriculum consists of a basic level (SIN-I) and an expert level (SIN-II) which are consecutive levels teaching both theoretical and hands-on skills using a symptom-based approach. Competency is assessed using written, oral and practical structured assessments at the end of each level. The goal is to implement national and international recommendations regarding the use of point-of-care ultrasound into clinical practice.
Literatur
Moore CL, Copel JA (2011) Current concepts point-of-care ultrasonography. N Engl J Med 364:749–757
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):2479–2502
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):1206–1227
Whitson MR, Mayo PH (2016) Ultrasonography in the emergency department. Crit Care 20(1):227. https://doi.org/10.1186/s13054-016-1399-x
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. https://doi.org/10.1155/2013/946059
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):401–406
Michels G, Breitkreutz R, Pfister R (2014) Value of lung ultrasound in emergency and intensive care medicine. Dtsch Med Wochenschr 139(45):2301–2307
Brown SM, Kasal J (2015) Bedside ultrasound in the intensive care unit: where is the evidence? Semin Respir Crit Care Med 36(6):878–889
Malbrain MLNG, De Tavernier B, Haverals S et al (2017) Executive summary on the use of ultrasound in the critically ill: consensus report from the 3rd course on acute care ultrasound (CACU). Anaesthesiol Intensive Ther 49(5):393–411
Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 1. Chest 128:881–895
Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 2. Chest 128:1766–1781
Dietrich CF, Goudie A, Chiorean L (2016) Point of care ultrasound: a WFUMB position paper. Ultrasound Med Biol 43(1):49–58
Neri L, Storti E, Lichtenstein D (2007) Toward an ultrasound curriculum for critical care medicine. Crit Care Med 35(5):S290–S304
Deutsche Gesellschaft für Ultraschall in der Medizin (2020) Basisausbildung Notfallsonographie. https://www.degum.de/arbeitskreise/notfallsonographie/kurse-kurscurricula/basisausbildung-notfallsonographie.html. Zugegriffen: 01.01.2020
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):766–770
Bleise S, Greim C‑A (2011) DGAI-zertifizierte Seminarreihe Anästhesie Fokussierte Sonografie – Modul 1: Grundlagen der Sonographie. Anasthesiol Intensivmed Notfallmed Schmerzther 46:750–754
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):756–759
Bahner DP, Goldman E, Way D et al (2014) The state of ultrasound education in U.S. medical schools: results of a national survey. Acad Med 89(12):1681–1686
Butter J, Grant TH, Egan M et al (2007) Does ultrasound training boost year 1 medical student competence and condence when learning abdominal examination? Med Educ 41:843–848
Dinh VA, Frederick J, Bartos R et al (2015) Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education. J Ultrasound Med 34(1):43–50
Royer DF, Kessler R, Stowell JR (2017) Evaluation of an innovative hands-on anatomy-centered ultra-sound curriculum to supplement graduate gross anatomy education. Anat Sci Educ 10(4):348–362
Hempel D, Schröper T, Pfister R et al (2019) Sonographieausbildung in der Notfall- und Intensivmedizin, Integration schon im Medizinstudium? Med Klin Intensivmed Notfmed 114(6):519–524. https://doi.org/10.1007/s00063-019-0550-2
Wong A, Galarza L, Duska F (2019) Critical care ultrasound: a systematic review of international training competencies and program. Crit Care Med 47(3):e256–e262. https://doi.org/10.1097/CCM.0000000000003626
No Authors listed (2017) Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med 69(5):e27–e54. https://doi.org/10.1016/j.annemergmed.2016.08.457
Roffi M, Patrono C, Collet JP et al (2016) 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European society of cardiology (ESC). Eur Heart J 37(3):267–315
Ibanez B, James S, Agewall S et al (2017) 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. https://doi.org/10.1093/eurheartj/ehx393
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(27):2129–2200
Konstantinides SV, Meyer G, Becattini C et al (2019) 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory society (ERS). Eur Heart J. https://doi.org/10.1093/eurheartj/ehz405
Hempel D, Michels G (2019) Shock—review for clinicians. Dtsch Med Wochenschr 144(13):884–891. https://doi.org/10.1055/a-0828-9675
Habicher M, Zajonz T, Heringlake M et al (2018) S3 guidelines on intensive medical care of cardiac surgery patients : hemodynamic monitoring and cardiovascular system-an update. Anaesthesist 67(5):375–379
Janssens U, Jung C, Hennersdorf M et al (2016) Empfehlungen zum hämodynamischen Monitoring in der internistischen Intensivmedizin. Kardiologe 10:149–169
Werdan K et al (2019) S3-Leitlinie Infarkt-bedingter kardiogener Schock – Diagnose, Monitoring und Therapie. https://www.awmf.org/leitlinien/detail/ll/019-013.html. Zugegriffen: 01.03.2020
Michels G, Wengenmayer T, Hagl C et al (2019) Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR): consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Clin Res Cardiol 108:455. https://doi.org/10.1007/s00392-018-1366-4
Gans SL, Pols MA, Stoker J (2015) Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg 32(1):23–31. https://doi.org/10.1159/000371583
Gutt C, Jenssen C, Barreiros AP et al (2018) Updated S3-guideline for prophylaxis, diagnosis and treatment of gallstones. German society for digestive and metabolic diseases (DGVS) and German society for surgery of the alimentary tract (DGAV)—AWMF registry 021/008. Z Gastroenterol 56(8):912–966. https://doi.org/10.1055/a-0644-2972
Ross M, Brown M, McLaughli K et al (2011) Emergency physician–performed ultrasound to diagnose cholelithiasis: a systematic review. Acad Emerg Med 18:227–235. https://doi.org/10.1111/j.1553-2712.2011.01012.x
Pereira J, Bass GA, Mariani D et al (2019) Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European society for trauma and emergency surgery (ESTES) consensus statement. Eur J Trauma Emerg Surg. https://doi.org/10.1007/s00068-019-01197-z
Schnell J, Beer M, Eggeling S et al (2018) Management of spontaneous pneumothorax and postinterventional pneumothorax: German S3-guideline. Zentralbl Chir 143(S 01):S12–S43. https://doi.org/10.1055/a-0588-4444
Price S, Platz E, Cullen L et al (2017) Expert consensus document: echocardiography and lung ultrasonography for the assessment and management of acute heart failure. Nat Rev Cardiol 14(7):427–440. https://doi.org/10.1038/nrcardio.2017.56
Konstantinides SV, Meyer G (2019) The 2019 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 40(42):3453–3455. https://doi.org/10.1093/eurheartj/ehz726
Oks M, Cleven KL, Cardenas-Garcia J et al (2014) The effect of point-of care ultrasonography on imaging studies in the medical ICU: a comparative study. Chest 146(6):1574–1577. https://doi.org/10.1378/chest.14-0728
Brogi E, Bignami E, Sidoti A et al (2017) Could the use of bedside lung ultrasound reduce the number of chest x‑rays in the intensive care unit? Cardiovasc Ultrasound 15(1):23. https://doi.org/10.1186/s12947-017-0113-8
Michels G, Hempel D, Pfister R et al (2019) Emergency ultrasound and echocardiography in patients with infarct-related cardiogenic shock. A survey among members of the German society of medical intensive care and emergency medicine. Med Klin Intensivmed Notfmed 114:434. https://doi.org/10.1007/s00063-018-0431-0
Michels G, Zinke H, Möckel M et al (2017) Empfehlungen zur Ultraschallausbildung in der internistischen Intensiv- und Notfallmedizin: Positionspapier der DGIIN, DEGUM und DGK. Med Klin Intensivmed Notfmed 112:314. https://doi.org/10.1007/s00063-017-0285-x
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
D. Hempel und G. Michels geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Additional information
Redaktion
M. Buerke, Siegen
Rights and permissions
About this article
Cite this article
Hempel, D., Michels, G. Sonographie in der internistischen Intensiv- und Notfallmedizin. Med Klin Intensivmed Notfmed 116, 301–306 (2021). https://doi.org/10.1007/s00063-020-00688-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00063-020-00688-x
Schlüsselwörter
- Point-of-Care-Ultraschall
- Bettseitige Ultraschalluntersuchung
- Fokussierte Thoraxsonographie
- Fokussierte Echokardiographie
- Fokussierte Abdomensonographie
- Intensivmedizin