doctors

Workshop for doctors

• Ultrasound – introduction to the craft
• Ultrasound image acquisition and optimization
• Ultrasound of the urinary tract, basic concepts
• Ultrasound of the urinary tract, beyond basics
• VExUS
• Testicular ultrasound
• Inguinal region ultrasound and hernia detection
• FAST i eFAST
• Ultrasound of the Peripheral Veins on Legs
• Ultrasound Guided Vascular Access
• Ultrasound of the Upper Abdomen
• RUSH protocol in hypotension and shock
• Ultrasound Guided Procedures
• FoCUS heart ultrasound
• Ultrasound of the heart – beyond basics
• Ultrazvuk of Peripheral Arteries in Acute Ischemia
• Lung ultrasound
• Introduction to locomotor system: knee an Achilles’ tendon
• Ultrasound in the diagnosis of appendicitis
• Enhanced Cardiopulmonary Resuscitation – ultrasound and mechanical compression device
• Regional anesthesia in acute setting
• Optic Nerve Sheath Diameter Ultrasonography
• Ultrasound of the gut

Workshop for doctors

Ultrasound – introduction to the craft

Lecturer: Ivan Gornik
Prior knowledge: not required
Format: lecture 20 min
Learning objectives: introduction for the attendants with no prior knowledge with basic ultrasound concepts so they can participate in the workshops

Ultrasound image acquisition and optimization

Lecturer: Ivan Gornik
Prior knowledge: not required
Format: introductory lecture, practical workshop
Learning objectives: introduction to basic image optimization techniques for better visualization during ultrasound exams

Ultrasound of the urinary tract, basic concepts

Lead instructor: Bojana Radulović
Workshop level: basic
Prior knowledge: not required
Format: introductory lecture, demonstration of most common pathologies, hands-on practice
Practical application: Ultrasound is an important diagnostic tool in recognizing urinary pathology, as well as the preferred imaging modality for evaluating patients with azotemia and oliguria. The kidneys and urinary bladder are easily examined due to their favorable anatomical position, and most acute pathological changes in the kidneys and urinary bladder are easily detected by ultrasound.
Learning objectives: The aim of the workshop is to learn how to obtain an optimal ultrasound view of the urothelial tract, to examine the normal ultrasound appearance as well as the most common pathological conditions (e.g., dilatation of the collecting system, kidney stones, acute and chronic kidney damage, bladder diverticula, large tumors of the urinary bladder, etc.).

Ultrasound of the urinary tract, beyond basics

Lead instructor: Bojana Radulović
Workshop level: advanced
Prior knowledge: Basic knowledge of renal ultrasound with basic color Doppler
Format: introductory lecture, case presentation, practical session
Learning objectives: The aim of the workshop is to provide participants with advanced, more extensive knowledge and practical experience in the assessment of various renal conditions. The workshop includes the use of Doppler ultrasound and an explanation of its application in various renal and circulatory pathologies. We will demonstrate the procedures for assessing RI, ultrasound signs of renal venous congestion, assessment of renal artery flow, and the “urethral jet”.

VExUS

Lead instructor: Toni Ivičić
Workshop level: advanced
Prior knowledge: visualization of hepatic veins and portal vein, visualization of renal veins
Format: introductory lecture, demonstration of common US findings, hands-on practice
Practical application: Correct assessment of a patient's volume status is one of the most common problems in acute care. Most doctors who use ultrasound rely mainly on measurements of the inferior vena cava, although studies have shown that this is not optimal. In the last four years, a 4-step ultrasound protocol was developed and validated: VExUS (Venous Excess Ultrasound Score), which proved to be a superior non-invasive way of quantifying venous congestion. The examination assesses the degree of venous congestion not only of the IVC, but also of the liver, intestines and kidneys
Learning objectives: to explain the theory of this protocol, practice the four ultrasound positions for measuring VexUS and learn the interpretation of the findings

Testicular ultrasound

Lead instructor: Jasmin Hamzić
Workshop level: moderate
Prior knowledge: basic techniques of ultrasound examination in B-mode, color-Doppler and spectral Doppler
Format: introductory lecture, seminar with examples of normal and pathological findings
Practical application: Testicular ultrasound is an ideal non-invasive and non-ionizing test for testicular pathology. With the help of ultrasound, we can easily distinguish the etiology of pain or swelling in the testicular region, which includes testicular torsion or epididymitis/orchitis, as well as the assessment of signs of injury in the testicles after trauma. Ultrasound can easily detect intra- or extra-scrotal masses as well as other abnormalities
Learning objectives: to learn the technique of ultrasound examination of the testicles and recognition of normal and the most common pathological findings.

Inguinal region ultrasound and hernia detection

Lead instructor: Jasmin Hamzić
Workshop level: advanced
Prior knowledge: competent knowledge of abdominal ultrasound in B-mode
Format: introductory lecture, seminar with demonstration of common pathologies, hands-on practice on a healthy model
Practical application: Ultrasound is an excellent tool for evaluating pathology in the groin region, as the structures are superficial and easily viewable with a high-frequency probe. The method is non-invasive and available, and can significantly contribute to diagnostics in the emergency room.
Learning objectives: participants will learn to visualize relevant anatomical structures important for orientation during the examination, as well as the procedure of the examination in order to be able to identify the integrity of the inguinal and femoral canal and pathological changes in this region.

FAST I eFAST

Lead instructor: Alan Kvarantan
Workshop level: basic
Prior knowledge: basic ultrasound techniques
Format: introductory lecture with normal and common pathological findings, hands-on practice
Practical application: FAST (focused assessment with sonography for trauma) is designed to answer the question of whether there is free fluid in the chest and/or abdominal cavity in the context of trauma to the clinician at the patient's bedside. The premise behind using the FAST protocol is that in case of significant trauma in the chest and/or abdominal cavity there will be free fluid peresent. eFAST (extended FAST) is an upgrade of the FAST protocol in which we additionally search for free air in the chest. Pneumothorax is one of the significant pathological conditions that potentially endanger the life of our patient in the context of trauma, and its detection is of great importance when caring for the patient.
Learning objectives: independent performance of the FAST and eFAST protocols - knowledge and ultrasound imaging of typical places where fluid accumulates in the chest and abdominal cavity, identification of pneumothorax

Ultrasound of the Peripheral Veins on Legs

Lead instructor: Ivan Gornik
Workshop level: basic
Prior knowledge: not necessary, desirable basic ultrasound techniques
Format: introductory lecture, hands-on practice on a healthy model
Practical application: leg swelling and suspicion of DVT is a common clinical situation in acute medicine, the differential diagnosis is relatively broad, and ultrasound is crucial in establishing the diagnosis.
Learning objectives: participants will be able to independently perform an examination of the deep veins of the upper leg up to the popliteal vein and be familiar with the visualization of the deep veins of the lower leg

Ultrasound Guided Vascular Access

Lead instructor: Ivan Gornik
Workshop level: moderate/advanced
Prior knowledge: basic ultrasound techniques
Format: introductory lecture, hands-on practice on a vascular model
Practical application: ultrasound examination has become an indispensable part of procedures during which blood vessels are punctured either for vascular access or for vascular interventions, and today it is actually unacceptable to perform them without direct ultrasound control.
Learning objectives: in this workshop, participants will be able to practice the techniques of visualising and puncturing blood vessels under direct ultrasound control.

Ultrasound Guided Procedures

Lead instructor: Ivan Gornik
Workshop level: moderate/advanced
Prior knowledge: abdominal and lung ultrasound techniques
Format: introductory lecture, hands-on practice on a model of thorax and model of abscess.
Practical application: any puncture, even the simplest one like paracentesis, is nowadays performed with at least previous ultrasound visualization, and sometimes (as in the case of pericardiocentesis and abscess puncture) under direct control and ultrasound visualization.
Learning objectives: in this workshop, participants will be able to practice pleural and pericardial puncture techniques, as well as ultrasound-guided puncture of fluid collections (abscesses).

Ultrasound of the Upper Abdomen

Lead instructor: Tomislav Knotek
Workshop level: basic/moderate
Prior knowledge: not necessary, desirable basic ultrasound knowledge
Format: introductory lecture with examples of pathology, hands-on practice on a healthy model
Practical application: ultrasound of the upper abdomen is the most common ultrasound examination in the emergency department and is the most common introduction to the world of ultrasound for doctors in acute medicine. Knowledge of this method enables the practicing physician to independently clarify the clinical problems encountered.
Learning objectives: participants will learn to independently present the structures of the upper abdomen (liver, bile ducts, gall bladder, pancreas, spleen, abdominal aorta, inferior vena cava) and recognize normal and most common pathological findings.

RUSH protocol in hypotension and shock

Ultrasound in the diagnosis of appendicitis
Lead instructor: Ivan Gornik
Workshop level: advanced
Prior knowledge: FOCUS ultrasound, FAST protocol, lung ultrasound, venous ultrasound Format: introductory lecture, seminar with case presentation
Format: introductory lecture, seminar with case presentation
Practical application: Hypotension and shock are a common problem in the care of acute patients, the etiology is relatively diverse and quick identification of the cause enables rapid targeted treatment and improves outcomes. In a large number of cases, ultrasound enables a quick and reliable clarification of the cause of shock (hypotension), and the RUSH protocol enables a systematic approach to the ultrasound examination of a hypotensive patient.
Learning objectives: to unify the knowledge of ultrasound techniques in the RUSH protocol for rapid identification of the cause of hypotension/shock

FoCUS heart ultrasound

Lead instructor: Daniel Lovrić
Workshop level: moderate
Prior knowledge: basic ultrasound techniques
Format: introductory lecture, case presentation, hands-on practice on a healthy model
Practical application: FoCUS (Focused Cardiac UltraSound) is a standardized approach to ultrasound examination of the heart that enables reliable acquisition of information on the size and function of the left and right ventricles, the presence of pericardial effusion and volume status, which can be crucial in planning the care of acute patients. It is not an echocardiographic examination, but an orientation about the key elements of heart function.
Learning objectives: presentation of the heart from basic projections and obtaining information about the size and function of the ventricles and the existence of a pericardial effusion.

Ultrasound of the heart – beyond basics

Lead instructor: Daniel Lovrić
Workshop level: advanced
Prior knowledge: knowledge of ultrasound imaging of the heart in basic projections, knowledge of Doppler techniques
Format: introductory lecture, case presentation, practical exercises on healthy models and patients
Practical application: FoCUS examination of the heart provides basic information about the structure and function of the heart, but we often need additional information, primarily about the function of the myocardium and valves.
Learning objectives: This advanced workshop will teach participants the techniques of measuring cardiac output by measuring flow through the LV outflow tract, measuring pressure in the LV/PA, analysis of regional systolic activity, basics of ultrasound analysis of valve function

Lung ultrasound

Lead instructor: Radovan Radonić
Workshop level: novice
Prior knowledge: not required
Format: introductory lecture, case presentation, hands-on practice on a healthy model
Practical application: lung ultrasound is a simple method that can be obtained in a short time valuable information about pathological lung changes. In many situations it is complementary or superior to the lung roentgenogram. With a good understanding of the principles of review, the method is quickly adopted and it helps the clinician to better understand the patient's condition.
Learning objectives: Understanding the principles of lung ultrasound. Recognition of normal ultrasound findings, findings in cardiogenic pulmonary edema, pneumonia, ARDS, pneumothorax, atelectasis, suspected pulmonary embolism and pleural effusions.

Introduction to locomotor system: knee an Achilles’ tendon

Lead instructor: Mislav Čavka
Workshop level: moderate
Prior knowledge: basic ultrasound techniques and anatomy of the joints
Format: introductory lecture, demonstration of usual pathology, hands-on practice on a healthy model
Practical application: soft tissue injury is common in emergency department and definitive diagnosis may be hard to come by without MR imaging. Ultrasound in the emergency setting enables high quality information about the integrity of muscle and connective tissues which can help guide treatment
Learning objectives: to visualize basic structures in the examined joints and be able to recognize common pathologies

Ultrazvuk of Peripheral Arteries in Acute Ischemia

Lead instructor: Ana Marija Alduk
Workshop level: moderate
Prior knowledge: basic knowledge of vascular ultrasound
Format: introductory lecture with examples of common pathology, hands-on practice on a healthy model
Practical application: acutely compromised arterial circulation in the extremities requires fast recognition and initiation of treatment. Although angiography is the gold standard of diagnosis, Doppler examination enables the acquisition of key information without delay and the planning of further processing.
Learning objectives: participants will learn the examination algorithm and indications, peripheral artery examination techniques and distinguish between normal and pathological findings.

Ultrasound in the diagnosis of appendicitis

Lead instructor: Tomislav Knotek
Workshop level: moderate
Prior knowledge: familiarity with abdominal ultrasound
Format: introductory lecture, hands-on practice on a simulator
Practical application: pain in the lower right quadrant and suspicion of appendicitis are everyday situations in emergency admission. Ultrasound, along with clinical examination and laboratory processing, enables the placement of or ruling out the diagnosis in the vast majority of patients. The method is quickly learned, and with practical experience it becomes an important everyday diagnostic tool.
Learning objectives: participants will learn the diagnostic algorithm, examination technique and diagnostic criteria for appendicitis, and also the most common doubts and errors during examination.

Enhanced Cardiopulmonary Resuscitation – ultrasound and mechanical compression device

Lead instructor: Bojana Radulović
Workshop level: moderate
Prior knowledge: basics of lung, heart and vascular ultrasound
Format: introductory lecture, case presentation
Practical application: the main advantage of POCUS during cardiopulmonary arrest is the detection of reversible causes, such as tamponade, pulmonary embolism, hypovolemia and tension pneumothorax, and in recent timing and differentiation of real and "pseudo" pulseless electrical activity. Use of UZV for time cardiopulmonary resuscitation, in addition to revealing reversible causes, can also help in diagnosis other conditions, such as valve failure, left and right ventricle failure, and heart rupture.
Learning objectives: to understand the purpose and role of ultrasound during resuscitation

Regional anesthesia in acute setting

Lead instructor: Marina Banović
Workshop level: advanced
Prior knowledge: previous experience in regional anesthesia or the use of ultrasound with different interventions; needle-probe coordination
Format: introductory theoretical part with the definition of indications and contraindications, scanning protocols
Practical application: peripheral nerve blocks are used as part of a multimodal approach to the treatment of an acutely injured patient. Their use reduces the consumption of systemically prescribed opioids as well as their possible side effects, and is often the only safe modality of analgesia and anesthesia for some patients.
Learning objectives: learn scanning protocols and how to choose the right block for a specific indication with the type of anesthetic, its dosage and total volume

Optic Nerve Sheath Diameter Ultrasonography

Lead instructor: Branko Malojčić
Workshop level: novice
Prior knowledge: not required
Format: introductory lecture, case presentation, hands-on practice on a healthy model
Praktična primjena: The optic nerve sheath diameter (ONSD) is an intracranial pressure (ICP) surrogate that can be imaged by Point of Care ultrasonography (POCUS). The optic nerve is surrounded by the extension of meningeal coverings of the brain. When the ICP increases, it causes a distention of the ONSD, which allows the use of this measurement by ultrasonography (US). ONSD POCUS is used in critical care, however, it is important to standardize ONSD ultrasonography measurements to improve research efforts and clinical utility.
Learning objectives: Understanding the principles of ONSD ultrasound. Recognition of normal ultrasound findings, findings in increased ICP, application in different clinical scenarios.

Ultrasound of the gut

Lead instructor: Silvija Čuković Čakva
Workshop level: advanced
Prior knowledge: ultrasound of the abdomen
Format: introductory lecture, case presentation, hands-on practice on a healthy model
Practical application:
Learning objectives: