Twelve tips for integrating ultrasound guided peripheral intravenous access clinical skills teaching into undergraduate medical education.

Peripheral Intravenous access (PIV) is a procedure undertaken by Medical Practitioners and Non-Medical Practitioners. Traditional PIV uses a visual and tactile technique to locate blood vessels close to the surface of the skin. Chronic medical conditions, dehydration, obesity and recurrent intravenous access can make PIV challenging.

Can we successfully teach novice junior doctors basic interventional ultrasound in a single focused training session?

Background: Ultrasonography is recognised as an invaluable imaging modality for assessing critically unwell patients and obtaining vascular access. Senior emergency medicine and anaesthetic clinicians will regularly use ultrasound-guided imaging to establish vascular access for unwell patients; however, junior doctors, who are routinely the first clinicians to review deteriorating patients, are not encouraged or required to develop basic ultrasound interventional skills and are therefore ill equipped to use ultrasonography.

Aim: To demonstrate that teaching basic interventional ultrasound skills to novice junior doctors in a single focused session is an achievable outcome.

The development of a pragmatic, clinically driven ultrasound curriculum in a UK medical school.

Whether ultrasound (US) should be incorporated into a medical undergraduate curriculum remains a matter of debate within the medical education arena. There are clear potential benefits to its early introduction particularly with respect to the study of living anatomy and physiology in addition to the learning of clinical skills and procedures required for the graduate clinical practice. However, this needs to be balanced against what is perceived as an added value in addition to financial and time constraints which may potentially lead to the sacrifice of other aspects of the curriculum.

Ultrasound probe grip: the afternoon tea technique.

Background: Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings.

Context: After reading Flood's paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique.

Innovation: The purpose of this correspondence is to highlight the 'afternoon tea technique' as a potential teaching method for probe stabilisation.

How to do it: bedside ultrasound to assist lumbar puncture.

For many neurologists, lumbar puncture is the only practical procedure that they undertake on a regular basis. Although anaesthetists and emergency physicians routinely employ ultrasound to assist lumbar puncture, neurologists do not. In this article, we outline the technique that we use for an ultrasound-assisted lumbar puncture, together with the evidence base that suggests that ultrasound has significant benefits.

Measurement and implications of postural changes in blood pressure.

Postural changes in blood pressure are a commonly elicited vital sign. It is important that the measurements are reproducible in order to be clinically meaningful. This article makes recommendations about how and what to document as part of the technique of recording, on the basis of the literature.