Table 7

The education and training goals for focused cardiac ultrasound (FoCUS) following an Indication, Acquisition, Interpretation, and Medical decision-making framework

Education/training goals in FoCUSPreferred learning tool
Indications and background knowledge
(may be pre-existing)
 Basic physics of ultrasound
 Cardiac anatomy/sonoanatomy
 Indications of FoCUS
 Hemodynamic instability or undifferentiated shock
 Cardiac arrest
 Pericardial effusion/tamponade: signs and symptoms
 Heart failure: signs and symptoms
 High cardiac risk patients
 Adjunct to physical examination
 Limitations and pitfalls
 Experience and skill set of performing physician
 No quantifiable data
 Functionality of equipment
Didactics
Image acquisition Ergonomics
 Transducer selection
 Patient positioning to optimize views
 Practice performing FoCUS views:
 Parasternal long axis
 Parasternal short axis
 Apical 4-chamber view
 Subcostal 4 chamber
 Subcostal inferior vena cava
Hands on training
Image interpretation Qualitative assessment of:
 Ventricular dimensions and systolic function
 Volume status/responsiveness
 Pericardial effusion/tamponade
 Gross anatomical abnormalities
 Gross signs of chronic heart disease
Hands on training
Clinical case discussions
Medical decision-making Ability to integrate exam findings to patient management
 Evaluate for and determine treatment for the following pathology
 Local anesthetic systemic toxicity
 Aortic stenosis
 Hypovolemia
 Massive pulmonary embolism
 Pericardial effusion/tamponade
 Gross ventricular failure
Clinical case discussions