Tag Archives: Nelson

Faculty group photo

SonoSweden 2014 course

At the end of January, Bret Nelson joined an incredible team of international a faculty for the largest SonoSweden course to date. Course director Christofer Muhr hosted this unique, intensive hands-on conference at the scenic Yasuragi hotel in Stockholm, Sweden. Over thirty faculty and one hundred participants took part in this three-day course.

Among the faculty were lung ultrasound pioneer Vicki Noble, Matt Dawson and Mike Mallin (creators of the Ultrasound Podscast) and others from around the globe.

Registration is not yet open for the 2015 course, but check out the SonoSweden website for a countdown timer- there were over 100 people on the waiting list for this year’s course!

Last days of the stethoscope?

GH TOC 500x381 Last days of the stethoscope?In the current issue of Global Heart (journal of the World Heart Foundation), several Mount Sinai authors have published articles on the use of point-of-care ultrasound. Phil Andrus wrote about focused cardiac ultrasound, Jennifer Huang co-authored a review of ultrasound use in IVC assessment, Daniel Lakoff described ultrasound incorporation into rapid response teams in inpatient wards, and Bret Nelson and Amy Sanghvi wrote a review of non-cardiologist use of cardiac ultrasound.

Bret Nelson and Global Heart Editor-in-Chief Jagat Narula wrote the editorial for the issue, which focused on improvements in ultrasound technology creating new opportunities and markets for ultrasound use. One theme of the editorial was whether ultrasound could replace the stethoscope, and as you may imagine the press has picked up on that thread!
CBS news visited Mount Sinai and interviewed Drs. Nelson and Narula.
And a number of media outlets have covered the story, including Popular Mechanics, the Huffington Post and others.
Mount Sinai has incorporated ultrasound into medical student education in Gross Anatomy since 2006, and last year began a curriculum in focused ultrasound as part of the physical examination course.

ACEP National Faculty Teaching Award

The American College of Emergency Physicians awarded its annual National Faculty Teaching award in Seattle this year during the Academic Affairs committee meeting.

Bret Nelson, Director of the Emergency Ultrasound Division at Mount Sinai, was one of four faculty honored nationally.

NFTA group 500x332 ACEP National Faculty Teaching Award

Left to right: Federico E. Vaca, MD, MPH; Vicken Y. Totten, MD, MS, FACEP; Bret P. Nelson, MD, RDMS, FACEP; Yashwant Chathampally, MD, MS

According to ACEP,

The American College of Emergency Physicians sponsors a national faculty teaching and junior faculty teaching award to honor outstanding educators in emergency medicine. These awards are designed to support emergency medicine faculty in their efforts to achieve academic advancement, as well as support the continued academic development of the specialty. The awards recognize superior teaching activities including didactic lectures, clinical instruction, the development of innovative educational programs, as well as the endorsement by faculty, residents, and students.

20130725-140353.jpg

2013 Tri-State Ultrasound Fellow Conference

The first annual Tri-State Ultrasound Fellow Conference kicked off today at Lenox Hill Hospital in New York City. The first day of this two-day course focused on administrative issues in ultrasound, featuring nationally recognized speakers from all around the area.

Bret Nelson from the Icahn School of Medicine at Mount Sinai discussed faculty development, including:

  • Creating a niche
  • The educator portfolio
  • Making connections

Here are a few references from the talk:

 

20130725 104514 2013 Tri State Ultrasound Fellow Conference

20130725 104528 2013 Tri State Ultrasound Fellow Conference

20130725 104543 2013 Tri State Ultrasound Fellow Conference

20130725 104558 2013 Tri State Ultrasound Fellow Conference

20130725 105801 2013 Tri State Ultrasound Fellow Conference

20130725 105815 2013 Tri State Ultrasound Fellow Conference

20130725 140224 2013 Tri State Ultrasound Fellow Conference

20130725 140233 2013 Tri State Ultrasound Fellow Conference

20130725 140254 2013 Tri State Ultrasound Fellow Conference

20130725 143536 2013 Tri State Ultrasound Fellow Conference

Ultrasound Zen

ZenStone 500x333 Ultrasound Zen To image something which moves, you must remain still. To image something which is still, you must move.

If you think on this long enough, the point is self-evident and requires no explanation. Or, just see some examples below.

We are pretty well adapted to seeing three dimensions at a time. Thus when imaging a moving structure like the heart, we hold the probe in a fixed position to obtain standard views. This allows us to focus on the movement, and cardiac presets optimize temporal resolution at the expense of spatial resolution. We are then seeing two spatial dimensions and one temporal dimension (heart moving in time).

D Shaped Left Ventricle from Sinai EM Ultrasound on Vimeo.

It is very difficult to appreciate the anatomy and function of the heart, for example,  when the probe is moving.

In contrast, imaging the right upper quadrant for fluid in Morison’s pouch requires a slow fan through the liver, diaphragm, and kidney. This allows us to appreciate the entire potential space where fluid can collect. Abdominal imaging is optimized for spatial resolution at the expense of temporal resolution, so be sure to move the probe slowly. Fanning through the entire structure of interest will often reveal pathology which was missed with a single-plane scan. Small gallstones, small amounts of peritoneal or pleural fluid, saccular aneurysms, and other maladies can fool a novice sonographer who isn’t thorough. In this case we are seeing three spatial dimensions.

FAST1 RUQ pos from Sinai EM Ultrasound on Vimeo.

So, keep your audience in mind when you are creating scans. Should you fan through the static anatomy, or let the movement of the structures speak for themselves?

Ultrasound education at MSSM

VscandemoBretNelson2 500x375 Ultrasound education at MSSMThe Mount Sinai School of Medicine recently welcomed its incoming first-year class in its traditional White Coat Ceremony. In a day filled with inspirational talks by prominent faculty and medical leaders, students don their new white coats and receive a stethoscope at a special ceremony attended by family, friends and faculty members.

This year, Sinai’s medical students were also introduced to a new curriculum in point-of-care ultrasound:

“First-year medical students traditionally learn about the human body by dissecting the cadavers and eventually by examining the patients, and the examination ranges from inspection and palpation to listening with the help of a stethoscope and interpreting the sounds of the heart, lungs and blood vessels,” says Jagat Narula, MD, PhD, who is the principal investigator of this research study and the director of the cardiovascular imaging program at Mount Sinai School of Medicine. “With handheld ultrasound, our medical students will have the ability to see live images of inside the body projected onto a handheld screen in real time.  It’s an innovative educational concept that can modernize medical education.”

As part of an educational research study, GE Vscan ultrasound machines will be distributed to groups of medical students who will learn to use the technology to image the heart, lungs, and abdomen. Mount Sinai is the first school in New York to initiate such a curriculum.

David Muller, MD, dean of medical education at Mount Sinai School of Medicine, says of the research study, “First-year medical students will learn how to identify and assess the anatomical structures within cardiac, thoracic and abdominal applications. We are excited to incorporate the portable ultrasound in our curriculum as we strive to revolutionize the way medicine is taught.”

The curriculum will augment what is being taught in the Art and Science of Medicine course, which is the students’ introduction to physical examination.

Bret Nelson, MD, RDMS, FACEP, associate professor and director of emergency ultrasound in the department of emergency medicine at Mount Sinai, will be leading the new curriculum with Dr. Narula. Says Dr. Nelson, “Point-of-care ultrasound represents a distinct skill set beyond physical examination. Te increased penetration of sonography through a variety of clinical practice environments means students will need to understand this technology to excel in patient care through their careers.”

vscanGroup 500x375 Ultrasound education at MSSM

FROM LEFT: Jagat Narula, MD, PhD; David Muller, MD; Mike Harsh, Vice President and Chief Technology Officer, GE Healthcare; Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Mount Sinai School of Medicine and Executive Vice President for Academic Affairs, The Mount Sinai Medical Center; Tom Gentile, President and Chief Executive Officer, GE Healthcare; Bret Nelson, MD; and Lisa Kennedy, Director, Strategic Marketing, healthmagination

“Today, we are thrilled to play a part in this important research project by providing Mount Sinai’s first-year medical students with the power of portable ultrasound technology, as they take the first step towards becoming our next generation of doctors,” says Tom Gentile, president and CEO of GE Healthcare Systems. “Tools like Vscan have the ability to help transform the physical exam and today’s announcement reaffirms GE Healthcare’s commitment to research and improving patient care by helping enhance the physician’s ability to quickly and accurately diagnose patients.”

For the full story, please check out the October 1 edition of Inside Mount Sinai.

ACEP 2012- Ultrasound Management Course

 

The ACEP Emergency Ultrasound Section hosted its annual Ultrasound Management Course on Sunday October 7. This year’s course was organized by Vivek Tayal, Troy Foster and Bret Nelson. Special thanks to ACEP organizers Marilyn Bromley and Julie Williams who were instrumental in putting the course together.

Almost 120 participants registered for this full-day course which served as a whirlwind introduction to the operational aspects of emergency ultrasound. Participants interacted with each other as well as national ultrasound leaders in small group breakout sessions covering topics such as quality assurance, image management systems, reimbursement issues, and others.

Faculty for the course (listed below) hailed from across the United States and brought enormous expertise to bear in their lectures and small group sessions.  We look forward to their continued involvement as the course expands, as well as your suggestions for topics for next year’s course!

Emergency Ultrasound Management Course 2012

Sunday Oct 7th 2012 Denver

Course Agenda

EM US Director M. Blaivas
Introductory Education J. Kendall
Equipment Purchase V. Noble
Hospital Credentialing R. Jones
Quality Improvements P. Hunt
Breakout session All faculty
Politics of EUS P. Sierzenski
Continuing Program Education B. Nelson
EUS Coding/Reimbursement J. Resnick
Essential Software M. Stone
Workflow Solutions M. Byrne
Electronic Medical Record V. Tayal
Machine Maintenance A. Dewitz
Tying it all Together R. Geria

 

Breakout Sessions:

  1. Coding/reimbursement I (J. Resnick)
  2. Coding/reimbursement II (S. Hoffenberg)
  3. Machine purchase/maintenance (A. Dewitz)
  4. Archiving and QA solutions I (M. Stone)
  5. Archiving and QA solutions II (M. Byrne)
  6. The Director’s job- negotiations, pitfalls, strategies (R. Geria)
  7. Politics (local/national), hospital credentialing (V. Noble)
  8. The QA process (R. Lewiss)
  9. Ultrasound Education- training your faculty and yourself (J. Kendall)