Emergency Ultrasound

us babyThe University Of Vermont Department Of Emergency Medicine Section of Emergency Ultrasound was established in 2012 to promote excellence in the diagnostic and procedural application of bedside sonography. Focus was initially on the education of UVMMC faculty and regional emergency physicians, promoting the highest regional standards of patient care through the use of point of care ultrasound (POCUS). This included the procurement of advanced ultrasound systems and building a state of the art interface between those POCUS systems, the EMR, and PACS. The program has grown to include a 4th year medical student elective, a 4-year longitudinal POCUS curriculum at the UVM Larner College of Medicine, a Trans-esophageal Echocardiography (TEE) program, a research program, and an active EM POCUS interest group. The program also coordinates with the UVM Sim Lab to offer diverse continuing medical educational POCUS opportunities supporting EM and other medical specialties. These include Echo-guided Life Support (EGLS), weekly image review/didactic sessions, and regular hands-on workshops supporting integration of POCUS for clinical care. Ultrasound Section faculty are active participants in regional, national, and international POCUS development. This includes supporting the successful implementation of POCUS programs in resource-limited settings through education and through remote quality assurance image review.  

 

Emergency Medicine Residency

The UVMMC ED Ultrasound Section longitudinal residency curriculum supports comprehensive resident training in ultrasound with the expectation that residency graduates excel in the clinical application of ultrasound as a core aspect of emergency medical care. The curriculum includes an initial intensive POCUS “boot camp,” a two week rotation early in the PGY 1 year, dedicated scanning shifts during each EM rotation, weekly image review/didactic sessions, and the opportunity for an advanced elective and POCUS research. Residents will become facile at all core ACEP scanning applications and in the use of TEE for critical resuscitation. Senior residents will have the opportunity to become local and international mentors in POCUS education and in ultrasound research.  

Medical Student Education  

Wendell teaching St. Lucia

The four-year integrated ultrasound curriculum at the Robert Larner College of Medicine at the University of Vermont is a comprehensive longitudinal course in point of care ultrasound (POCUS). The curriculum begins in the first weeks of medical school and continues throughout all four years of medical training with the intent that students become competent in using POCUS in clinical patient care. During the first year, students start with a Fundamentals of Ultrasound course which introduces them to ultrasound and integrates online learning modules with hands-on training sessions. The first year curriculum continues as the Foundations of Ultrasound course which parallels the study of anatomy and also complements the Foundations of Clinical Sciences course. In the Foundations of Ultrasound course students use ultrasound to correlate anatomy as they learn clinical exam skills. They learn basic ultrasound applications including cardiac, aortic, biliary, thoracic, and renal, and are introduced to recognition of pathology with POCUS.  The second year of the integrated ultrasound curriculum builds upon skills learned in the first year and then introduces new and more advanced point of care ultrasound applications. Online modules and hands-on training cover musculoskeletal, cardiovascular, renal, obstetrical, neurovascular, and respiratory applications. Students also learn how to incorporate these applications into clinical patient care.  The third year of the integrated ultrasound curriculum combines online learning modules and hands on training sessions which focus on POCUS in the clinical setting. Family Medicine, Internal Medicine, Emergency Medicine, Surgery and OBGYN clerkships all have integrated POCUS components. The fourth year of the integrated ultrasound curriculum solidifies all that has been taught in the previous three years and continues to teach the application of POCUS to clinical medicine.  An emergency department elective incorporates all applications taught earlier in the curriculum through additional online didactics and intensive scanning sessions for patients presenting with diverse pathologies.  Students in this elective are also encouraged to focus on an area of interest or modality not covered previously. The fourth year also offers a radiology elective, research opportunities, and independent study electives relating to POCUS. 

Research  

The Emergency Ultrasound Section’s research program works in coordination with the UVM EMRAP program. We focus on new applications for point of care ultrasound and on outcome studies examining the impact of point of care ultrasound on patient care.  These include multidisciplinary projects with other specialties including radiology, urology, and critical care.  

Faculty 

Lindsay Reardon, MD
Assistant Professor 
Director, UVM EM Ultrasound Section 

Dr. Reardon graduated from the University of Colorado School of Medicine and was in the first EM residency class at Dartmouth-Hitchcock in New Hampshire. During her fellowship at Hennepin County in Minneapolis, she traveled to Jinja, Uganda to teach pediatric lung ultrasound to providers treating children with pneumonia. After Fellowship Dr. Reardon had the opportunity to help start an EUS Fellowship program at Stony Brook on eastern Long Island. She has taught bedside sonography and lectured at courses in Saint Lucia, Chile, Colombia, Costa Rica, and Fiji. 

Keith Curtis, MD 
Associate Professor

Dr. Curtis has been passionate about point of care ultrasound since early in his residency training. While training at the University of Utah he focused on emergency and critical care ultrasound with an emphasis on airway management. He described a technique for ultrasound guided cricothyroidotomy which has been used successfully in patients who were otherwise unable to be successfully intubated. He has published related research and is passionate about ultrasound education.  Dr Curtis has taught regionally, nationally and internationally. He has been a faculty educator for echo-guided life support and has been teaching point of care ultrasound internationally in India, Nepal and Bhutan. Dr Curtis is currently the director of a four-year integrated ultrasound curriculum at the Larner College of Medicine.   

Nicholas Aunchman, MD
Associate Professor 

Dr. Aunchman was born and raised in the state of Vermont and has happily made a career out of working and educating at UVM. He caught the ultrasound fever while in residency and went on to complete the Ultrasound Leadership Academy for his post-residency ultrasound training. Following completion of his fellowship, Nick set up an ultrasound program at our community affiliate, Champlain Valley Physicians Hospital, integrating POCUS into the PACS system there and taking on the role of Ultrasound Director. He has taught at a local and national level and has helped to teach and integrate ultrasound into the medical school curriculum. He also teaches nationally with The Ultrasound Podcast group and teaches EGLS. His interest centers on cardiac ultrasound, ultrasound education, and helping other departments throughout the hospital to integrate POCUS into everyday clinical practice.  

Neil Krulewitz, DO
Assistant Director, Emergency Ultrasound Fellowship
Director of Ultrasound Education, Emergency Medicine Residency
Director, Emergency Ultrasound, Elizabethtown-Ticonderoga ED
Assistant Professor 

Dr. Krulewitz attended medical school at the University of New England before training in Emergency Medicine at the University of Utah. Surrounded by POCUS experts in Utah, Dr. Krulewitz developed a passion for critical care and resuscitative ultrasonography, particularly echocardiography, early in training. After completing fellowship in Emergency Ultrasound at the University of Utah, he pursued board certification in Critical Care Echocardiography. Dr. Krulewitz continues translating his passion for emergency ultrasound into research projects predominantly focused on improving resuscitation with transthoracic and transesophageal echocardiography, and by educating residents and fellows. He has lectured locally as well as nationally on these topics, but most enjoys bringing his knowledge to the bedside with residents.