UNC has an active ultrasound program in the emergency departments at both UNC and Wake Med. This begins early in the residency with both a full-day ultrasound orientation course and a dedicated "ultrasound/procedures" month in the intern year. At the end of this month, on average the intern will acquire 200 ultrasound exams and will become proficient at FASTs, right upper quadrant, AAA, pelvic, and limited cardiac exams.
The philosophy is that by becoming comfortable with ultrasound early on, it will become an indispensable clinical tool throughout residency and beyond. There are dedicated ultrasound faculty who will provide bedside teaching as well as image review. There are comprehensive didactics and hands-on sessions throughout the year on basic ultrasound applications but also on secondary applications such as ophthalmic exams, DVT exams, and ultrasound-guided procedures.
The emergency medicine ultrasound director is Bobby Park, MD. He received his fellowship training in emergency ultrasound at Highland General Hospital in Oakland, CA. He has served as emergency ultrasound director at Duke University Medical Center for 3 years, but then realized he liked a lighter shade of blue. He has two primary interests in emergency ultrasound: ultrasound-related biomedical device development and a passion for teaching ultrasound in a practical way that will impact daily clinical medicine.
The ultrasound program at UNC focuses on learning "real world skills" so that graduates of the residency program will utilize focused, bedside sonography to enhance the physical diagnosis and treatment for a wide array of ED presentations: cardiopulmonary arrest, trauma, dyspnea, vaginal bleeding, abdominal pain, and kidney stones to name a few.
With the assistance of teaching faculty at both UNC and WakeMed, UNC residents participate in didactic lectures and hands-on teaching labs for:
- biliary complaints
- cardiac evaluation
- renal imaging
- early and late pregnancy
- central line placement
- abscess drainage
- foreign body removal
Teaching labs are supported by representatives of Sonosite, GE, Aloka and Medison.
Emergency Medicine residents perform a dedicated rotation in ultrasound, precepted by ultrasound-trained ED faculty at UNC and WakeMed. Residents are expected to compile a large collection of verified studies in order to graduate from the residency program, emerging from training with ACEP-compliant credentials in ultrasound. Dr. Bobby Park (WakeMed) and Dr. Janet Young (UNC) supervise the resident rotations. Dr. Young also precepts the fourth-year medical student elective in Emergency ultrasound.
The UNC Emergency Department also has ultrasound-trained nursing staff to aid in the placement of difficult peripheral IV catheters. These nurses serve as a resource for other nursing staff and ED physicians for patients in whom a central line is not desirable.