Our institution has developed an in-house, multidisciplinary neonatal point of care ultrasound (POCUS) program with an internal credentialing process. All first-year fellows are given protected time to attend the initial credentialing course (POCUS 101), which typically takes place in September.
This opportunity allows fellows to develop their bedside diagnostic and procedural ultrasound skills as they advance through their neonatal-perinatal medicine training. Fellows can dedicate time to further training in POCUS to hone their skills or participate in ongoing POCUS-related quality improvement projects in the NICU.
We anticipate adding additional fellow education in cardiac POCUS by December 2025.
Kristen Clark, NNP, Devon Swofford, DO (fellow), Jess Kris, MD (fellow), Jess Lewis, MD
Training
POCUS 101
For all first-year fellows in September
- Introduction to POCUS
- Ultrasound knobology (knobs, buttons, controls)
- Physics of ultrasound
- Anatomy review
- Umbilical catheter assessment and placement
- Peripheral arterial placement
- Bladder assessment
- Spine assessment for static lumbar puncture
POCUS 201
Available to all fellows who have completed POCUS 101
- Lung ultrasound/assessment
- Upper and lower extremity PICC assessment and placement
Weekly meetings
We host weekly in-person/zoom meetings to review each ultrasound image with our NICU POCUS leadership team and all available credentialed and training providers. This ensures the accuracy and reproducibility of each individuals’ images and coach learners on methods to improve their technique and to optimize image acquisition.
Team
Our team is currently led by Tasnim Najaf, MD, and Jess Lewis, MD, faculty in the Division of Newborn Medicine, Kristen Clark, Neonatal Nurse Practitioner (NNP), and Jess Kris, MD, third year neonatal-perinatal medicine fellow. Our credentialed providers include many faculty, neonatal-perinatal medicine fellows, and neonatal nurse practitioners with the goal to have all first-year fellows internally credentialed by the end of their first year.
Credentialing
After completing POCUS 101, each provider must complete 10 scans with a credentialed provider to become accustomed to probe maneuvers, the indicated place for each anatomic area they are interrogating, and baseline foundational knowledge in the procedure and ultrasound images. After completing these 10 scans, 25 independent scans must be completed for each diagnostic anatomic region (e.g., UVC/UAC, lung, bladder, spine) and then reviewed by our POCUS team for quality assurance/approval. An example of our credentialing schema and suggested education can be seen below.
Curriculum
| Background | Bladder | UVC/PICC | Lung |
|---|---|---|---|
| Core reading Groves, J Perinatol, 2018 Somnath, US Quarter, 2014 Core videos Introduction to POCUS | Core reading Schallem, Am J Crit Care, 2020 Core videos POCUS101 Bladder Intro | Core reading Meinen, Perinatel, 2019 Ren, Am J Perinatal, 2021 Core videos US-Guided UVC Insertion POCUS for PICC Insertion/Tip ID | Core reading Raimondi, Ped Research, 2018 De Martino, Pediatrics, 2018 Core videos Introduction to LUS LUS disease pathologies |
| Didactic lecture POCUS Bootcamp | Didactic lecture Intro to Bladder Ultrasound | Didactic lecture POCUS for IVC and Catheter ID | Didactic lecture LUS and LUS Score in the NICU |
| Didactic assessment Successful completion | Minimum 10 scans – Showing 2-view images – Estimating bladder volume | Minimum 25 scans UVC and LE PICC (min. 15 UVC) | Minimum 25 scans – Rule in/out PTX and effusion – Calculate LUS score |
| Maintenance – Independent scanning and logging in REDCap – Submission of images for QA – Participation in QA Meetings |