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Graduate Medical Education

​PGY1 Core Rotation

The PGY1 Ultrasound Rotation is centered in the emergency department at Denver Health Medical Center.  During this 2-week rotation, residents  obtain the basic skills needed to perform point-of-care ultrasound in the clinical setting.  This rotation consists of lectures, hands-on scanning, direct teaching by the fellows, and video review of image acquisition and interpretation.

For more details:

PGY3 Advanced Rotation

The PGY3 Ultrasound Rotation is dedicated to confirming competency in core emergency point-of-care ultrasound skills introduced during the PGY1 rotation.  Residents will complete a 1-week rotation at the University of Colorado with dedicated teaching objectives including advanced echo, trans-vaginal ultrasound, nerve blocks, lung, ocular applications. 

Point-of-care ultrasound approaches to syndromes such as undifferentiated hypotension, abdominal pain, and dypsnea will be emphasized.  The format of this rotation is flipped classroom and interdisciplinary in nature with faculty from critical care, simulation, sports medicine, and the emergency point-of-care ultrasound.


PGY-3 Advanced Track Point-of-Care Ultrasound
Welcome to the PGY-3 Ultrasound Rotation. This new rotation will have you scanning with faculty throughout the week. We are hoping to make each session as compact and educational as possible.
Point-of-Care Course Topics
1) Basic echo review and advanced echo techniques
2) Lung
3) Pelvic
4) Ultrasound guided Peripheral Nerve Blocks
5) Joint Arthrocentesis and Tendon Pathology
6) DVT
7) Ocular
8) Simulation is setting of undifferentiated pathology
9) Trans Esophageal Echo
10) Biliary
Course Objectives
1) Ability to utilize ultrasound to work up patients with undifferentiated hypotension
2) Ability to utilize ultrasound to work up patients with undifferentiated dyspnea
3) Proficiency in applications necessary for objectives 1 and 2
4) Proficiency in MSK applications
5) Exposure to critical care ultrasound which includes scanning in the MICU and exposure to trans-esophageal echo 
Begins: Monday at 8:00
Ends: Friday by 17:00
1) 5 DVT US studies 
2) 5 advanced cardiac echo studies 
3) 5 lung scans
4) 2 TV scans
5) 5 Ocular scans
6) 5 Biliary scans 
7) Perform 3 USGPIV
1) You are expected to attend the University Point-of-Care Ultrasound meeting and present 5 different types of studies for review.
2) You are expected to participate in QA of studies performed in the department during the week.
Critical Care
1) Please attend the TEE hands on simulator session.
1) E-books: Introduction to Bedside Ultrasound, Volume 1 and 2.  Matt Dawson and Mike Mallin.



1.  Transducers

2.  Patient positioning

3.  Demonstrate proper technique required to obtain and optimize the 4 standard transthoracic views of the heart with consistent probe and screen orientation in the subxiphoid, parasternal, and apical windows.

4.  Correctly identify the four heart chambers and great vessels

5.  Recognize and interpret RA and RV dilatation

6.  Correctly identify pericardial effusions and tamponade physiology

7.   Differentiate pericardial and pleural effusions

8.   8 EPSS, Estimate global LV systolic function 

9.   Evaluate volume responsiveness using a variety of methods 

10. Evaluate global longitudinal strain and peak strain 



Key points:

1. Correct positioning of patient

2. Identify key structures starting at the inguinal ligament. Identify the common femoral vein, Saphenofemoral junction, and bifurcation of the femoral and deep femoral veins in the proximal thigh.

3. Fully compress the veins with the transducer to demonstrate no intraluminal clot.​​​

4. In the popliteal fossa, identify the popliteal artery and vein. The vein often lies deep to the artery. Fully compress the vein with the transducer.



1. Demonstrate correct scan technique and image acquisition in the minimal criteria 6 positions of the thorax

2. Demonstrate and verbalize understanding of the following concepts

        Lung sliding



        Pleural fluid

3. Demonstrate and verbalize understanding of the following lung diagnoses

        No acute findings







1. Shoulder


        Humeral head ultrasound position (related to dislocation)


        AC joint ultrasound position

        Biceps tendon



2. Elbow




3. Hip


4. Knee




1. Identify normal anatomy and key anatomic relationships: eyelid, cornea, sclera, anterior chamber, iris, pupil, lens, vitreous body, retina, optic nerve sheath.

2. Recognize globe rupture, ocular foreign bodies, lens displacement, vitreous hemorrhage, retinal detachment, retrobulbar hematoma, increased intracranial pressure. See Bedside Ultrasound iBook by Mike Mallin and Matt Dawson Volume 2 Chapter 16 for examples.

3. Optic nerve sheath diameter (ONSD) can be used to identify patients with increased intracranial pressures. ONSD >5 mm is associated with elevated intracranial pressures. However, there is wide variability in normal ONSD in asymptomatic patients with normal intracranial pressure.



1. Femoral Nerve Block

2. Forearm Blocks

        Medial, Ulnar, Radial Nerve Block

3. Ankle Blocks

        Posterior Tibial Nerve Block

4. Brachial Plexus

        Interscalene Block for Shoulder Dislocation



Learning objectives undifferentiated hypotension

1. Demonstrate hemodynamic interpretation and management of the hypotensive patient

2. Demonstrate and interpret poc u/s evaluation for IUP

3. Demonstrated and interpret poc u/s evaluation for DVT/PE 

Learning objectives undifferentiated dyspnea

1. Demonstrate cardio-pulmonary interpretation and management of hypotensive patient

2. Demonstrate and intepret poc u/s evaluation of ADHF

3. Demonstrate and interpret poc u/s evalution of COPD

4. Demonstrate and interpret poc u/s evaluation of PNA/sepsis 



1. Transducer

2. Patient positioning

3. Demonstrate proper technique required to obtain and optimize the 4 standard transesophageal views of the heart

        Mid-esophageal 4 chamber

        Mid-esophageal long axis with and without color

        Transgastric short axis

        Bi-caval view with M-mode

4. Recognize fine ventricular fibrillation

5. Recognize a pericardial effusion



1. Identify an IUP

        gestational sac

        double decidual sign

        yolk sac

        fetal pole


        endomyometrial mantle (greater than or equal to 7mm)

2. Identify features of an ectopic

        free fluid around the uterus

        no IUP in uterus

        identify ovaries in adnexa

        identify suspicious masses in adnexa


1. Demonstrate correct scan technique and image acquisition in the minimal criteria 

2. Demonstrate and verbalize understanding of the following concepts

        Sagittal view with evaluation of the neck of the gallbladder 

        Recording and demonstration of the portal vein with common bile duct

        Transverse view of the gallbladder with sweep through

3. Demonstrate and verbalize understanding of the following diagnoses

        No acute findings

        Biliary colic


        Acute cholecystitis​

​ ​


 List of Rotators











James Engeln 


Christopher Erley


Arian Anderson


Chelsea Dymond


Jeremy Collado

Nick Kelly


Davida Hemmy



Adam Esch

Reid Haflich

Sasha Kaiser


Alexander Quinones


Sarah Markus

Nik Matsler


Joe Noack


Liz Malik


Irene Hurst (PEM)

Matt Mendes


Ross Orpet


Lesley Pepin


Sam Paskin-Flerlage



Melisa Tanverdi (PEM)


Stephen Gradwohl (PEM)





Dec02 Final.JPG

For Transvaginal US, call the day prior and find out the schedule for pelvic ultrasounds being performed.

Main Desk: 720-848-1864 (Ask for Britt Smith or Tracy Bieker)

Tracy Bieker’s direct line: 720-848-1880​


 Flipped Classroom Assignments



 Post-Rotation Evaluation