This document discusses the use of acute care sonography by nurses. It notes that point-of-care ultrasound conducted by nurses can be faster, non-invasive, avoid radiation exposure, and help address surge capacity issues in imaging departments. Nurses trained in focused ultrasound exams can help assess patients' airways, breathing, circulation, and detect fractures or foreign bodies. A pilot program trained 10 nurses in these acute care ultrasound skills over 1.5 days, significantly increasing their confidence in using ultrasound for common trauma assessments.

1. Acute Care Sonography for
Nurses (ACSN)
Sonia Chauhan
Trauma Nurse Coordinator,
JPNATC,AIIMS
sonia_aiims@yahoo.co.in

2. Point of care-USG
 Faster , Non-invasive
 No Radiation exposure
 Remote settings - Austere environment
 Pregnancy
 Pediatric population
 No Need of specialized technician
 Mass casualties scenarios

3. Why Ultrasound by Nurses ?
 ‘Point of care’ ultrasound : a visual tool
 Blinded procedures: ? Patient safety issue
 During Mass Casualty scenarios
 Addressing the surge capacity issues in imaging
Department

4. Red Area Team (RAT)
EP2
EN1 HA2
EP1
HA1
EP3
TL
EN2
CODE RED – ATLS
CODE BLUE - ACLS
HEAD END
TL Team Leader
EP1 Emergency Physician 1 (Surgery)
EP2 Emergency Physician 2 (Medicine)
EP3 Emergency Physician 3
(Orthopedics)
EN1 Emergency Nurse 1
EN2 Emergency Nurse 2
HA1 Hospital Attendant 1
HA2 Hospital Attendant 2

6. LET US RESUSCITATE
IN A VISUAL
WAY………!

7. Airway
 Assessment and
Management of Difficult
Airway
Assisting in Intubation

8.  Assisting in Surgical
Procedure
 Tube Confirmation

9. Confirm tube placement in 3 sec.
Sens.& Sp. :-- 100%
J Ultrasound Med 2011; 30:671–676

11. Breathing
Rule out Pneumothorax Haemothorax – E- FAST

12. Circulation
 Assessment of fluid volume status - IVC
Assessment

13. Circulation
 Ultrasound Guided I/ V access

14. Acute Care Sonography For Nurses

16. Circulation- FAST Exam
1. Subxiphoid
2. Right upper
quadrant (RUQ)
3. Left upper
quadrant (LUQ)
4. Suprapubic

17. D: Seeing through Closed Eye

18. D- Intra Cranial Pressure monitoring
 Optic Nerve Sheath Diameter assessment

19. E: Fracture detection


20. Foreign Body

21. Acute Care Sonography for Nurses
(ACSN)
forum for empowering acute visual
medicine globally

22. Acute Care Sonography for Nurses
(ACSN)
 Conducted along with AIIMS Ultrasound Trauma
Life Support Course
 Duration – One and half day
 No. of participants- 10 Nurses
 Course contents:
 Lectures followed by
 Hands on skill stations

23. Baseline confidence questionnaire

24. Post Test Confidence questionnaire

25. Breathing
4.5
4
3.5
2.5
2
1.5
1
0.5
0
3
Baseline
Post-Course
1
4.27
Breathing
n=88

26. n=88

27. Future……..
 Independent Course
 Duration – One day
 No. of participants- 32 Nurses
 Course contents:
 Lectures followed by
 Hands on skill stations

29. AIIMS nurses study group
1st,2nd and 3rd Prize in WINFOCUS-2011
 To study the diagnostic accuracy of bedside ultrasound done by
nurses for identifying fractures in patients with orthopaedic trauma
presenting to emergency department of a level 1 trauma centre
 ‘A Prospective evaluation of “focused assessment with sonography
for trauma” done by Emergency Nurses and its comparative
analysis with radiologists performance in identifying fluid during
initial resuscitation of trauma’
 Accuracy of Bedside Ultrasound done by Emergency nurse to rule
out Traumatic Pneumothorax in the E D

30.  “Join the mission with a vision to
empower yourself in rescue to
resuscitation while caring with
compassion, commitment and
competency towards the patient whom
we care”.