“"A Light...in Dark Places, When All Other Lights Go Out” – Implementing a Paediatric Point-of-Care-Ultrasound (p-PoCUS) Program for Anaesthesiology Trainees”

Background: Attention was recently^1,2 devoted to developing PoCUS capabilities in our field. In Emergency Medicine (EM)³ and Intensive Care (IC)^4,5 these are crucial. Advances of these capabilities to the paediatric population⁶ are beginning systematically⁷ – with task-force curricula⁸, textbooks^9,10, and qualifications developed^11,12.None are from Anaesthesiology.

Objective: We seek to amend this bane by devising a 1-year curriculum for introducing, refining, and consolidating p-PoCUS skills to Residents and Fellows.

Methods: The intervention will include a thrice yearly introductory workshop, hands-on OSCE, delivered by specialists in Paediatric Radiology, EM, IC, and Anaesthesiology. Thence, participants will be assigned a mentor to supervise their monthly usage of p-PoCUS in anesthetic practice (pre-operative evaluation, peri-operative usage, EM settings, IC unit). Participants will maintain an image portfolio to ascertain strong and weak points with their mentors and devising, accordingly, appropriate patient exposure and exercises. Each participant will be his own control in evaluating the change in image quality and quantifying cases where p-PoCUS enhanced clinical management. Three knowledge tests will be administered (introductory, post-workshop, and post-1-year mentorship (P1YM)). The portfolio will undergo a P1YM evaluation, as well. The program will be national, with residents and fellows acceptance on merit and recommendation basis. Training in Paediatric ultrasonography prevents participation, though exceptions will be allowed. The top 10% residents/fellows will be offered positions as trainers in the program and endowed personalized support towards formal qualifications (e.g. FASE).

Conclusion: Thus, a continuous cadre of Anaesthesiology & IC oriented p-PoCUS specialists and educators will be created.