Handbook

I.  Introduction.

 

The Ultrasound Challenge (formerly known as the Ultrasound Olympics) was conceived in 2009 by David Bahner MD, RDMS and fourth year medical students Matthew Dell’Aquila and Justin Dzik at The Ohio State University. A full description of rules, event details, scoring rubric, sample images, and prizes is available in the Ultrasound Challenge 2014 Handbook.  We recommend reviewing this Handbook before the event. A concise description of the various scans and scoring is included here as a quick reference.

 

II. Event rules.


1.       This year’s event will take place on Saturday, February 15, 2014 from 8 AM-1 PM. Each participant must arrive at least 30 minutes before the start of their scheduled scanning session.

 

2.       The six events are as follows:

A. FAST

B. Aorta

C. Cardiac

D. Pelvic

E. Vascular Access

F. Carpal Tunnel Self-Scan

 

A.      FAST

The FAST exam consists of 4 views:

·       Subxiphoid: Image of the heart with identification of the four heart chambers.

·       Perihepatic: Image and identification of the liver and right kidney.

·       Perisplenic: Image and identification of the spleen and left kidney.

·       Pelvic: Image and identification of the bladder.

Please see page 5 of the Ultrasound Challenge Handbook for a more detailed description of the FAST scan. Sample images are available on page 40 of that reference.


B.      Cardiac

The cardiac exam for the purposes of this competition consists of 2 views:

·       Parasternal Long Axis: Image of the heart in long axis with identification of the left atrium, left ventricle, and right ventricle.

·       Parasternal Short Axis: Image of the heart in short axis with identification of the left ventricle and right ventricle and either mitral valve OR papillary muscles.

Please see page 5 of the Ultrasound Challenge Handbook for a more detailed description of the Cardiac scan. Sample images are available on page 42 of that reference.

 

C.       Aorta

The aorta exam consists of 3 views:

·       Celiac Trunk: Image of the aorta where the celiac axis branches with identification of the celiac trunk, vertebral body, aorta, and IVC.

·       Superior mesenteric artery (SMA): Image of the aorta visualizing the SMA with identification of the SMA, vertebral body, IVC, and aorta.

·       Bifurcation: image of the aorta at the level of bifurcation into the left and right common iliac arteries with identification of each.

Please see page 5 of the Ultrasound Challenge Handbook for a more detailed description of the Aorta scan. Sample images are available on page 43 of that reference.

 

D.      Pelvic

Accomplished using a phantom nicknamed “Lulu,” the exam consists of 5 views:

·       Sagittal view of Uterus/Cervix: sagittal image of the uterus with identification of the cervix and endometrial stripe.

·       Coronal view of Uterus: coronal image of the uterus with identification of the endometrial stripe.

·       Estimated gestational age: sagittal image of the uterus with identification of the embryo.  The age of this embryo must be estimated using the “Crown-Rump Length” calculator feature.

·       Left Ovary: Dual screen image of LEFT ovary measuring the volume of entire ovary.  Ovary, side (right vs. left), and cyst must be identified on this image.

·       Right Ovary: Dual screen image of RIGHT ovary measuring the volume of entire ovary.  Ovary, side (right vs. left), and cyst must be identified on this image.

Please see page 5 of the Ultrasound Challenge Handbook for a more detailed description of the Pelvic scan. Sample images are available on page 44 of that reference.

 

E.       Vascular Access

Demonstrate correct technique for performing ultrasound-guided venous cannulation.  Prior to performing the procedure, participants must visualize the vessel in the long axis, sweep the vessel in the short axis, and view the “North Star” sign (where the needle presented just under the skin, vessel, and probe are all in alignment).  Participants must also maintain constant pressure on the syringe and use a short jab to penetrate the vessel.  Proper scanning techniques including contact with the patient and use of appropriate motions are important.  For full scoring details, see section VII of the Handbook. Sample images are available on page 45 of the Handbook.

 

F.       Carpal Tunnel Self-Scan

The participant scans his or her own forearm proximal to the wrist to view the carpal tunnel.  The proctor will assist the participant by freezing the image on command, however participant must take all other steps to obtain the image and label it appropriately.

·       Median Nerve: Image of carpal tunnel with identification of the median nerve, flexor digitorum profundus, and flexor digitorum superficialis.

Please see page 6 of the Ultrasound Challenge Handbook for a more detailed description of the Carpel Tunnel scan. Sample images are available on page 46 of that reference.

 

3.       Time for each event will be kept by the models/proctors at each station.  Time will begin immediately when the master timekeeper indicates that scanning may begin.  Time will conclude when the Olympian captures his or her final image AND vocalizes “time” to the judge.  A maximum of twelve minutes are allowed for the FAST and Pelvic scans.  A maximum of eight minutes are allowed for the Cardiac and Aorta scans.  A maximum of five minutes are allowed for Carpal Tunnel Self-Scan and Vascular Access.

 

III. Scoring.

 

1.       Participants are required to save appropriate images during scanning.  Judges will score participants based on image quality following the completion of all events.  Judges will review stored images to determine a participant’s overall score in an event.

 

A.  Single Event Scoring: Cardiac, FAST, Pelvic, Aorta, Self-Scan

Each contestant will be given a “quality score” for their images in each event, based on the B-QUIET model of image grading. A copy of this rubric is available in the Handbook on page 10. All ties will be broken using the fastest time between participants with the same score.

 

B.  Single Event Scoring: Vascular Access

Each contestant will be scored on scanning and procedural technique.  A scoring rubric is available in the Handbook on page 8. All ties will be broken using the fastest time between participants with the same score.