By the end of the Women’s POCUS Course, participants will be able to:

PHYSICS AND INSTRUMENTATION

⊣ Understand basic ultrasound physics
⊣ Use common ultrasound terms
⊣ Adjust display depth based on the exam being performed
⊣ Adjust gain (overall and time-gain compensation)
⊣ Adjust focal zone and change the number of focal zones during an exam
⊣ Use harmonic imaging
⊣ Choose a specific transducer frequency based on the area being scanned
⊣ Understand the uses of various transducers – curved, linear, phased array
⊣ Modify the exam based on gray-scale artifacts
⊣ Understand mechanical and thermal index, demonstrate how to modify these
⊣ Practice ALARA (“as low as reasonably achievable”) principle
⊣ Recognize the mechanisms for potential biological effects
⊣ Use knowledge of sound reflection to modify scanning technique
⊣ Clean and disinfect transducers in accordance with manufacturer’s guidelines


HEMODYNAMICS

⊣ Modify the exam based on Doppler artifacts
⊣ Document embryonic and/or fetal cardiac activity
⊣ Evaluate measurements of blood flow velocitie


GYN ULTRASOUND

⊣ Define indications for performing a point of care ultrasound in a gynecologic patient
⊣ Assess and record uterine position
⊣ Perform gynecologic sonography exams on post-menarchal, premenopausal and post-menopausal patients
⊣ Assess both adnexa, including posterior and anterior culdesacs
⊣ Identify endometrial fluid
⊣ Identify ovarian cysts/masses
⊣ Assess for causes of bleeding in gynecologic patients


OBSTETRIC ULTRASOUND

⊣ Define indications for performing a point of care ultrasound in an obstetric patient
⊣ Perform first trimester obstetric exams
⊣ Attempt to correlate HCG levels with abnormal pregnancies (ectopic, hydatidiform mole)
⊣ Identify the yolk sac
⊣ Identify an enlarged or echogenic yolk sac
⊣ Identify the double decidual sac sign
⊣ Identify an anembryonic pregnancy
⊣ Identify an ectopic pregnancy
⊣ Identify embryonic demise
⊣ Determine fetal number and chorionicity
⊣ Perform second and third trimester obstetric exams
⊣ Assess the shape of the fetal head at the level of the biparietal diameter (BPD)
⊣ Identify a lethal fetal head anomaly (ie, anencephaly, acrania, hydranencephaly, other)
⊣ Document the fetal diaphragm
⊣ Identify multiple gestations
⊣ Perform biophysical profile
⊣ Identify fetal demise
⊣ Assess for causes of bleeding in obstetric patients
⊣ Assess for appearance consistent with a placental abruption
⊣ Assess for appearance consistent with a low-lying placenta
⊣ Identify a pregnancy with oligohydramnios or anhydramnios
⊣ Identify a pregnancy with polyhydramnios


PROTOCOLS

Clinical standards and guidelines

⊣ Obtain pertinent clinical history as part of the exam
⊣ Review lab results as a part of the exam

Gynecologic exams

⊣ Check the results of a previous ultrasound exam
⊣ Inform a physician of findings that may be of an emergent nature
⊣ Measure uterine depth, width, and length
⊣ Use transabdominal scans in gynecologic patients
⊣ Use transvaginal scans in gynecologic patients
⊣ Measure the endometrium in the anteroposterior diameter
⊣ Identify intrauterine device (IUD) placement


OBSTETRIC

⊣ In the first trimester, measure gestational sac using the mean sac diameter
⊣ Measure the crown-rump length
⊣ Determine necessity of maternal bladder filling based on indication of the exam
⊣ Assess amniotic fluid
⊣ Measure the amniotic fluid index (AFI)
⊣ Establish fetal lie and presentation
⊣ Document placental location
⊣ Measure the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL)
⊣ Document the fetal stomach
⊣ Use both transabdominal and transvaginal ultrasound in obstetric patients; appropriate to the indication and gestation
⊣ Measure cervical length
⊣ Identify components of an incompetent cervix
⊣ Perform exams for assisted reproduction techniques
⊣ Tailor the exam to evaluate pregnancies where a maternal and/or fetal condition indicates a potential complication


PROFESSIONAL CONSIDERATIONS

⊣ Be familiar with professional organization guidelines for the use of ultrasound (AIUM, ARDMS, SDMS ACOG, ACNM, AWHONN)
⊣ Identify correct methods of image documentation and archiving
⊣ Describe guidelines for providing keepsake images
⊣ Tailor the exam to evaluate pregnancies where a maternal and/or fetal condition indicates a potential complication

Note: Fetal anatomy or anatomic survey is NOT covered in this class, since it is not considered a point of care exam. Fetal anatomy reviewed in this class is for identifying landmarks needed for appropriate biometric measurements.