Surgery FoCUS


– No matter what type of practice you have, you’ll be evaluating and managing patients with cardiovascular disease.  Bedside cardiovascular ultrasound can serve as an incredible adjunct to your physical exam.  It will vastly improve your understanding of cardiovascular anatomy, physiology, and pathology.  It’s also a ton of fun!

Why Focused Cardiac Ultrasound: A Case-Based Discussion (30 min)

– If you wonder why cardiac ultrasound is for you, take a look at this talk.  If you’re already convinced (and you are attending one of our workshops) you can watch it because it’s a fun talk but you could also move onto the vast sea of ‘How-to’ below.

What exactly is ”FoCUS”? (30 min)

–  An introduction to the concept of FoCUS as described by the American Society of Echocardiography (and interpreted by our echo group.)  Before you embark on your ultrasound training it is important for us to be on the same page regarding not only the immense value of these techniques but also their limitations.

Cardiac Anatomy for the New Echocardiographer (20 min)

– A brief review of anatomy to refresh your memory before beginning to scan.  Remember that the image is not the thing, and we’re always trying to construct a mental picture of our patient’s actual anatomy from the images we create.

HeartWorks How-to (10 min)

– The Department of Anesthesiology has an excellent HeartWorks cardiac ultrasound simulator.  If you’re spending time working with us you will likely have the opportunity to use this system.  This lecture is a brief introduction to the functioning of this awesome (but not always intuitive) simulator.

Basic Concepts of Ultrasound (22 min)

– Don’t be scared, this isn’t your college physics class reprised.  You don’t have to be able to calculate a Doppler shift to start using ultrasound in your practice, I promise!  You do need a basic understanding of how an ultrasound image is formed, how to adjust basic image settings, and what common artifacts look like.  That’s what Dr. Decou will review here.

FoCUS How-To (90 min)

– It’s hard to spend too much time with the basics, and these are absolutely the basics.  What do you do when you put the probe on the patient?  Watch these talks now, then come back to them as you continue to develop your skills.

Global Left Heart Evaluation (30 min)

– Assessment of the structure and global function of the left ventricle with Dr. Bledsoe.  The goal here is not to distinguish between an ejection fraction of 34% vs 36%!  We want to know if our patients’ LV function is not too bad, not so good, or terrible.

Global Assessment of the Right Ventricle (30 min)

– Similar concepts apply to Dr. Bledsoe’s discussion of global right ventricular function.  We’d like to know if our patient’s problem (clinical evidence of heart failure, hemodynamic instability, etc) could be related to global dysfunction of the right ventricle.

Basic LV Regional Wall Motion Evaluation (2o min)

– Identification of subtle regional wall motion abnormalities is challenging even for very experienced echocardiographers.  What you’re trying to identify is large areas of hypokinesis that could explain hypotension, or perhaps areas of scar that suggest old myocardial infarctions.  These are less subtle.  In this talk Dr. Curtis will review concepts of normal and abnormal myocardial wall motion and sequelae of infarction.

Basic Valvular Assessment (80 min)

– In this series of three lectures, we’ll review the normal anatomy of the aortic, mitral, and tricuspid valves as well as discuss findings of significant valvular stenosis and regurgitation.

FoCUS to the Rescue! (120 min)

– In this series of lectures, I’ll review the application of FoCUS in the assessment of the hemodynamically unstable patient.  This topic is a ton of fun, but there’s a lot to cover so I’ve broken the 200-some slides into more bite-sized portions.