Page 115 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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                 Implementing ultrasound in Dutch emergency departments after a two-day training 113
This study was conducted in the winter of 2014. This thesis was completed four years later. In the meantime, the Dutch EPs have made some substantial progress in the adoption and implementation of emergency department ultrasonography.
Much more emergency departments have now gained access to an ultrasound machine. Fur- thermore, basic ultrasonography training has become an integral part of the first year of the emergency medicine residents’ training curriculum.
In June 2017, the Dutch association of emergency physicians (NVSHA) adopted a program for EPs to become certified in basic emergency ultrasonography. EPs choosing to become an NVSHA-certified basic emergency ultrasonography provider must (1) participate in a two- day course, and (2) perform and record 250 examinations: 25 supervised and 25 unsupervised examinations in five distinct areas. These areas include (1) eFAST, (2) focused cardiac ultra- sonography, and ultrasonography of the (3) abdominal aorta, (4) inferior vena cava, and (5) lung. The certification is concluded with a written test and a practical exam.
The certification program is available to EPs that have completed their training and it will be implemented in the emergency medicine residents’ training curriculum in the near future.
Hence, many of the obstacles that this study identified are being resolved to varying degrees.
First, the obstacle of unavailable US machines is resolving gradually through the merits of individual EPs and EDs that acquire their own devices. The popularity of emergency ultraso- nography and the improving availability of devices might be helpful in this process.
Secondly, the lack of certification will now be resolved by the NVSHA in the coming years. Every EP and emergency medicine resident is now encouraged to become NVSHA-certified in basic emergency ultrasonography.
Thirdly, implementing basic emergency ultrasonography in the training curriculum and pro- moting the certification program will hopefully improve the EPs’ confidence in their skills and ultrasound diagnoses.
Finally, the three aforementioned improvements and the continued penetration of emergen- cy ultrasonography in the Dutch EDs will ultimately arouse the interest of the radiologists and strengthen collaboration with the EPs.

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