The UNC Emergency Medicine program understands that Point of Care Ultrasound (POCUS) can expedite diagnosis, lower healthcare costs, increase patient satisfaction, decrease length of stay, and most importantly saves lives. For that reason, ultrasound education is vital component of the UNC EM residency curriculum.

Learn about our Ultrasound Fellowship ProgramUltrasound Fellowship








 

As a resident at UNC, you will become an expert in not only image acquisition and interpretation but will also learn how to incorporate your findings into your clinical decision making. The UNC Emergency Department has a unique ability to upload bedside sonographic images directly to the patient’s chart. The resident will dictate their findings and can refer consultants to these images. Throughout the hospital and our consulting services, ultrasound is well known and respected. It is frequently a game changer for patient management and simplifies conversations amongst surgeons, cardiologists, obstetricians, and ophthalmologists.

Four ultrasound machines are available in the UNC ED, Two at WakeMed Raleigh, one at UNC Hillsborough, and one at WakeMed North. The vast majority of EM faculty are credentialed in POCUS. All images obtained are reviewed by ultrasound faculty for quality assurance and feedback is provided.

Highlights of the UNC ultrasound program:

  • Fun, enthusiastic ultrasound faculty provide constant support and dedicated scan sessions
  • Dedicated 4 week ultrasound block at the beginning of intern year
  • Portable Butterfly probes available for extra educational scanning
  • Resident scans are uploaded to patient’s EPIC chart for real time decision making
  • In person QA sessions providing scan feedback always available
  • All scans throughout residency will be reviewed and feedback messaged
  • Advanced ultrasound elective available to explore advanced MSK, nerve blocks, sports med, etc
  • Fellowship opportunities for those wanting to take their skills to the next level

Ultrasound Curriculum

Our ultrasound education is intentionally front loaded so that residents gain confidence and competence in ultrasound early on. During either the first or second month, residents partake in an intensive four week ultrasound block. During these four weeks residents cover all twelve core emergency ultrasound applications as identified by ACEP: Trauma, Pregnancy, Cardiac, Aorta, Thoracic, Biliary, Urinary Tract, Deep Vein Thrombosis, Soft Tissue/Musculoskeletal, Ocular, Bowel, and Procedural. Learning will be facilitated by asynchronous EMsono modules and supplemented with high-yield FOMED resources. Skill will be acquired by scanning sessions in the Emergency Department alongside our capable ultrasound faculty and experienced upper-level residents. These skills will be further perfected by weekly Quality Assurance sessions where the resident will receive valuable feedback. In addition to the ultrasound block, first year residents will choose an ultrasound topic which interests them, review a journal article on this topic, and present this topic at our weekly conference.

This first year curriculum provides a solid framework on which to build during your second and third years. Upper level residents are expected to incorporate ultrasound into their clinical practice. All scans are reviewed for quality assurance by the ultrasound faculty and feedback is provided.

Longitudinal education and spaced repetition in ultrasound are also provided throughout all three years of residency. The department’s weekly conference boasts regular lectures covering ultrasound basics as well as advanced ultrasound technique.

Our department now owns three handheld Butterfly probes for the specific purpose of resident education. These probes provide even more opportunities for scanning in the department, at conference, or when appropriate can be checked out to practice at home.

Ultrasound Concentration

There is an US concentration for junior/senior residents that has defined roles and responsibilities for student/resident US education, supervised US scanning, monthly US journal watch presentations, and research initiatives. Those in the US concentration are also responsible for organizing the annual UNC Sonogames! This entails resident teams tackling US questions that test fund of knowledge and sonographic skills!

SonoGames

At UNC, we don’t simply say we have a strong ultrasound program, we prove it at SonoGames. We have participated in the SAEM SonoGames for the past 5 years, have made into the final rounds each year, and took home the gold winning first of 83 teams in 2019.


The US team:

Sarah Stahmer, MD – Director of the UNC US program

Daniel Park, MD – Associate Director of the UNC US program

Christopher Howarth, MD – Clinical Manager of the Adult EM US program

Danny Migliaccio, MD – Head of Emergency Ultrasound Education

Mark Hoppens, MD – 2020-21 Resident Ultrasound Director

Links/list of recent US publications:

  • Pediatric Abdominal Bedside Ultrasound, A Comprehensive Guide to Making the Diagnosis, Part 1.Fender, K. Park, D., Migliaccio, D. Pediatric Emergency Medicine Reports, 23(7).
  • A 54-year-old male with abdominal pain secondary to superior mesenteric artery dissection.Teeter, W., Migliaccio, D. Stahmer, S. (Nov 2017). Visual Journal of Emergency Medicine
  • A 61-year-old male with undifferentiated hypotension (IVC mass). Palomba, K., Migliaccio, D. (Oct 2017). Visual Journal of Emergency Medicine
  • A 44-year-old male with cardiac amyloidosis.Saleeby, J., Migliaccio, D. (Oct 2017). Visual Journal of Emergency Medicine
  • 63 year old man with chest pain and shortness of breath. Stahmer S, Stenberg R. In: Weinstock MB, Klauer KM, Weingart SD, Henry GL. Bouncebacks! Critical Care. Columbus, OH: Anadem Publishing; 2019.