Using ultrasonography to perform needle procedures has been shown to improve patient outcomes when compared to using anatomical landmarks alone (Denys et al., Iwashima et al., Karakitsos et al.).

SonoSim offers a comprehensive library of modules designed to help physicians improve and refine their ultrasound-guided venous cannulation and centesis techniques, including internal jugular, femoral, subclavian, and peripheral line placement as well as paracentesis, pericardiocentesis, and thoracentesis techniques. Our Procedures Modules will teach learners the requisite psychomotor skills and cognitive task
awareness required to perform ultrasound-guided procedures in a remote, risk-free environment.

Ultrasound-Guided Procedure Training

Learning Ultrasound-Guided Procedures

The SonoSim Ultrasound-Guided Procedure Package offers over 33 hours of online content for practitioners looking to learn how to perform ultrasound-guided procedures.

The package is organized into 8 SonoSim Modules with 80 SonoSimulator® hands-on training cases across a variety of essential medical topics related to performing ultrasound-guided venous cannulations and centesis procedures.

Each SonoSim Module consists of didactic lessons, knowledge assessments, and SonoSimulator hands-on training cases.

Ultrasound-Guided Procedure
Hands-On Training Modules

Introduction to Ultrasound-Guided Procedures: Procedure Module Introduction to Ultrasound-Guided Procedures: Procedure Module
Peripheral Venous Access: Procedure Module Peripheral Venous Access: Procedure Module
Ultrasound-Guided Subclavian Vein Cannulation: Procedure Module Ultrasound-Guided Subclavian Vein Cannulation: Procedure Module
Ultrasound-Guided Internal Jugular Vein Cannulation: Procedure Module Ultrasound-Guided Internal Jugular Vein Cannulation: Procedure Module
Ultrasound-Guided Femoral Line Placement: Procedure Module Ultrasound-Guided Femoral Line Placement: Procedure Module
Ultrasound-Guided Paracentesis: Procedure Module Ultrasound-Guided Paracentesis: Procedure Module
Ultrasound-Guided Pericardiocentesis: Procedure Module Ultrasound-Guided Pericardiocentesis: Procedure Module
Ultrasound-Guided Thoracentesis: Procedure Module Ultrasound-Guided Thoracentesis: Procedure Module
References

Denys BG, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique. Circulation. 1993 May;87(5):1557-1562.
Iwashima S, Ishikawa T, Ohzeki T. Ultrasound-guided versus landmark-guided femoral vein access in pediatric cardiac catheterization. Pediatr Cardiol. 2008 Mar;29(2):339-342.
Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care. 2006 Nov;10(6):R162.

Sample Course Outlines

Introduction to Ultrasound-Guided Procedures: Procedure Module

Introduction to Ultrasound-Guided Procedures: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Introduction to Ultrasound-Guided Procedures
    • Background
    • Advantages
    • Literature Review
    • Indications
    • Informed Consent
  • Lesson: Fundamental Requirements
    • Technical Requirements
    • Psychomotor Skill Development
    • Procedural Skill Delay
  • Lesson: General Considerations
    • Pre-Procedure Planning
    • Ergonomic Considerations
    • Infection Prevention Practices
    • Low-Level Transducer Disinfection
    • High-Level Transducer Disinfection
    • Acoustic Coupling Gel Selection
    • Sterilization & Infection Prevention
  • Lesson: Procedure Preparation
    • Transducer Selection
    • Transducer Types
    • Imaging Windows & Optimization
    • Imaging Recognition & Interpretation
    • Ultrasound Imaging Planes
    • Procedure Complexity
    • In-Plane vs. Out-of-Plane Visualization Techniques
    • Static vs. Dynamic Image Guidance
    • Single- vs. Dual-operator Approaches
    • Needle Selection & Guides
  • Lesson: Sonographic Technique
    • Image & Transducer Orientation
    • Survey Regional Anatomy
    • Transducer & Instrument Manipulation
    • Imaging Adjuncts
    • Image Artifacts
    • Pearls & Pitfalls
  • Lesson: Summary
    • Course Summary
Peripheral Venous Access: Procedure Module

Peripheral Venous Access: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Background
    • Advantages
    • Literature Review
    • Case Study
  • Lesson: Anatomy
    • Sonographic Venous Anatomy
    • Venous Valves
    • Vein Characteristics
    • Venous Flow: Spontaneous
    • Venous Flow: Respirophasic
    • Venous Flow: Valsalva Maneuver
    • Venous Flow: Unidirectional & Augmentable
    • Sonographic Anatomy: Soft Tissue
    • Sonographic Anatomy: Soft & Hard Tissue
    • Sonographic Anatomy: Muscle
    • Sonographic Anatomy: Tendon
  • Lesson: Procedure Preparation
    • Transducer Selection
    • Image Optimization
    • Aseptic Technique
    • Sterile Coupling Gel
    • Tourniquet
    • Angiocatheter Selection
    • Machine & Body Positioning
    • Local Anesthetic
  • Lesson: Procedure Steps
    • Image Orientation
    • Survey Scan
    • Vessel Localization: Mid-Arm to Mid-Forearm
    • Vessel Localization: Distal Forearm
    • Vessel Assessment: Compressibility
    • Vessel Assessment: Thrombus Detection
    • Vessel Assessment: Nerve Identification
    • Color & Power Doppler Imaging
    • Pulsed-Wave Doppler Imaging
    • Transducer Orientation
    • Imaging Approaches & Visualization Techniques
    • Short Axis: Out-of-Plane Approach
    • Long-Axis: In-Plane Approach
    • Going From Short to Long Axis After Vein Location
    • Long Axis: In-Plane Approach
    • How Far Back from the Probe does the Needle Enter the Skin?
  • Lesson: Technical Tips & Pitfalls
    • Pitfall: Excessive Transducer Pressure
    • Tip: Center Target Vessel
    • Pitfall: Venous Tenting
    • Pitfall: Vessel Backwalling
    • Tip: Needle Jiggling
    • Tip: Precise & Patient Needle Manipulation
    • Tip: Catheter Handling
    • Tip: Catheter Withdrawal Rescue Technique
    • Tip: Catheter Withdrawal & Flush Rescue Technique
    • Tip: Needle Localization
  • Lesson: Summary
    • Short Axis: Out-of-Plane Approach
    • Long Axis: In-Plane Approach
    • Antecubital and Forearm Veins
    • Forearm and Hand Veins
    • Antecubital Fossa Veins
    • Antecubital Vein Cannulation
    • Forearm Veins
    • Forearm Vein Cannulation
    • Upper Arm Veins
    • Case Study One
    • Case Study Two
    • Sites to Avoid
    • Complications and Management
    • Pitfall Summary
    • Conclusions
Ultrasound-Guided Femoral Line Placement: Procedure Module

Ultrasound-Guided Femoral Line Placement: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Professional Discretion
    • Introduction to Ultrasound-Guided Femoral Vein Cannulation
    • Course Objectives
    • Literature Review
    • Indications
    • Contraindications
    • Consent
  • Lesson: Regional Anatomy
    • Surface Anatomy
    • Internal Anatomy
  • Lesson: Sonographic Anatomy
    • Femoral Triangle: Transverse View
    • Femoral Triangle: Longitudinal View
    • Sonographic Characteristics
    • Spontaneous & Non-Pulsatile Flow
    • Respirophasic Flow
    • Unidirectional & Augmentable Flow
    • Compressibility
    • Case Study
    • Image & Probe Orientation
  • Lesson: Procedure Preparation
    • General Considerations
    • Transducer Selections & Machine Settings
    • Ergonomic Considerations
    • Patient Positioning
    • Survey Scan
    • Infection Prevention Practices
    • Transducer Covers
    • Transducer Disinfection & Sterilization
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Local Anesthetic
    • Vessel Imaging vs. Needle Guidance
    • Transverse Approach
    • Short Axis: Out-of-Plane Guidance
    • Long Axis: In-Plane Guidance
    • Transverse vs. Longitudinal
    • Sonographic Confirmation
    • Post-Cannulation Confirmation
  • Lesson: Imaging Adjuncts
    • Visual & Physical Guides
    • Doppler-Mode Imaging
  • Lesson: Technical Tips & Pitfalls
    • Anatomical Tips
    • Troubleshooting: Guidewire Rescue
    • Hypotensive Patient Pitfalls
  • Lesson: Complications
    • Complications of Femoral Line Placement
    • Infectious Complications
  • Lesson: Summary
    • Course Summary
Ultrasound-Guided Internal Jugular Vein Cannulation: Procedure Module

Ultrasound-Guided Internal Jugular Vein Cannulation: Procedure Module

  • Lesson: Introduction
    • Introduction to Ultrasound-Guided Internal Jugular Vein Cannulation
    • Course Overview
    • Indications & Site Selection
    • Literature Review
    • Contraindications
    • Informed Consent
  • Lesson: Regional Anatomy
    • Surface Anatomy
    • Internal Anatomy
    • Anatomic Variation
  • Lesson: Sonographic Anatomy
    • Sonographic Characteristics
    • Dynamic Changes
    • Image & Probe Orientation
  • Lesson: Procedure Preparation
    • General Considerations
    • Transducer Selection & Settings
    • Ergonomic Considerations
    • Patient Positioning
    • Survey Scan
    • Infection Prevention Practices
    • Sterile Covers & Transducer Disinfection
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Imaging Approaches
    • Imaging Approaches & Needle Visualization Techniques
    • Local Anesthetic
    • Transverse Approach
    • Transverse Approach: Out-of-Plane Needle Guidance
    • Longitudinal Approach
    • Longitudinal Approach: Vessel Identification & In-Plane Needle Guidance
    • Longitudinal Approach: Cannulating & Threading the Guidewire
    • Case Study: Internal Jugular Vein Cannulation
    • Confirmation Steps
  • Lesson: Imaging Adjuncts
    • Visual & Physical Guides
    • Doppler-Mode Imaging
    • Color-Flow Doppler: Internal Jugular Vein
    • Pulsed-Wave Doppler: Internal Jugular Vein
    • Color-Flow Doppler: Common Carotid Artery
    • Pulsed-Wave Doppler: Common Carotid Artery
    • Color-Flow Doppler: Internal Carotid Artery
    • Pulsed-Waved Doppler: Internal Carotid Artery
  • Lesson: Technical Tips & Pitfalls
    • Pitfall: Backwalling
    • Pitfall: Extreme Respirophasic Variation
    • Pitfall: Excessive Collapsibility
    • Pitfall: Excessive Movement
    • Tip: Overcoming Vessel Tenting
    • Troubleshooting: Catheter Rescue
    • Troubleshooting: Guidewire Rescue
  • Lesson: Complications
    • Central Venous Cannulation Complications
    • Quality Improvement
  • Lesson: Summary
    • Course Summary
Ultrasound-Guided Subclavian Vein Cannulation: Procedure Module

Ultrasound-Guided Subclavian Vein Cannulation: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Introduction to Ultrasound-Guided Subclavian Vein Cannulation
    • Course Objectives
    • Literature Review
    • Indications
    • Contraindications
    • Informed Consent
  • Lesson: Regional Anatomy
    • Surface Anatomy
    • Internal Anatomy
  • Lesson: Sonographic Anatomy
    • Sonographic Imaging Approaches
    • Axillary & Subclavian Vascular Nomenclature
    • Infraclavicular Approach: Short-Axis View
    • Infraclavicular Approach: Long-Axis View
    • Supraclavicular Approach: Short-Axis View
    • Supraclavicular Approach: Long-Axis View
    • Image & Probe Orientation
    • Transducer Orientation
  • Lesson: Procedure Preparation
    • General Considerations
    • Transducer Selection & Settings
    • Ergonomic Considerations
    • Patient Positioning
    • Selecting an Approach: Supraclavicular vs. Infraclavicular
    • Survey Scan: Infraclavicular Approach
    • Survey Scan: Supraclavicular Approach
    • Infection Prevention Practices
    • Sterile Covers & Transducer Disinfection
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Local Anesthetic
    • Infraclavicular Cannulation
    • Infraclavicular Approach: Short-Axis View
    • Infraclavicular Approach: Long-Axis View
    • Infraclavicular Approach: In-Plane Cannulation
    • Infraclavicular Approach: Cannulation Confirmation
    • Supraclavicular Approach: Short-Axis View
    • Supraclavicular Approach: Long-Axis View
    • Supraclavicular Approach: In-Plane Cannulation
    • Post-Cannulation Confirmation
  • Lesson: Imaging Adjuncts
    • Visual & Physical Guides
    • Doppler-Mode Imaging
  • Lesson: Technical Tips & Pitfalls
    • Troubleshooting: Guidewire Rescue
    • Troubleshooting: Catheter Passage
    • Troubleshooting: Catheter Rescue
    • Tips: Anatomic Landmarks
  • Lesson: Complications
    • Complications: Central Vein Cannulation
    • Complications: Management
  • Lesson: Summary
    • Course Summary
Ultrasound-Guided Paracentesis: Procedure Module

Ultrasound-Guided Paracentesis: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Overview
    • Detection of Ascites
    • Ultrasound Guidance Benefits
    • Literature Review: Traditional vs. Ultrasound-Guided Paracentesis
    • Indications
    • Procedural Considerations
    • Contraindications (Cont.)
    • Informed Consent
  • Lesson: Regional Anatomy
    • Abdominal Wall Layers
    • Abdominal Wall Vasculature
    • Peritoneum, Mesentery, & Omentum
    • Abdominal Organs
  • Lesson: Sonographic Anatomy
    • Solid & Hollow Viscus Organs
    • Intestinal Wall
    • Ascites
    • Abdominal Wall & Vasculature
    • Case Study: Large-Volume Ascites
    • Case Study: Moderate-Volume Ascites
    • Case Study: Small-Volume Ascites
  • Lesson: Procedure Preparation
    • General Considerations
    • Transducer Selection & Machine Settings
    • Patient Positioning
    • Machine Orientation
    • Survey Scan
    • Paracentesis Sites
    • Static Image Guidance
    • Real-Time Image Guidance
    • Infection Prevention Practices
    • Transducer Covers & Sterilization
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Local Anesthetic
    • Skin Puncture Techniques
    • Needle Selection
    • Static Image Guidance
    • Real-Time Image Guidance
    • Catheter Removal
    • Case Study: Real-Time Image Guidance
    • Case Study: Multiple Prior Abdominal Surgeries
  • Lesson: Technical Tips & Pitfalls
    • Tip: Using Static vs. Real-Time Image Guidance
    • Tip: Troubleshooting Decreased Catheter Output
    • Tip: Catheter Rescue Technique
    • Tip: In-Plane, Real-Time Image Guidance During Small-Volume Paracentesis
  • Lesson: Complications
    • Complications
  • Lesson: Summary
    • Course Summary
Ultrasound-Guided Pericardiocentesis: Procedure Module

Ultrasound-Guided Pericardiocentesis: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Introduction to Pericardiocentesis
    • Overview of Pericardiocentesis
    • Pitfalls of Empiric & Landmark Techniques
    • Benefits of Ultrasound Guidance
    • Success Rate & Potential Complications
    • Clinical Indications for Emergency Pericardiocentesis
    • Cardiac Tamponade: Background
    • Cardiac Tamponade: Clinical Presentation
    • Cardiac Tamponade: Diagnosis & Intervention
    • Relative Contraindications
    • Informed Consent
  • Lesson: Regional Anatomy
    • The Heart
    • Anatomic Relationships
    • Cardiac Layers
    • Pericardial Effusion
  • Lesson: Sonographic Anatomy
    • Cardiac Anatomy
    • Pericardial Effusion
    • Pericardial vs. Pleural Effusion
    • Pericardial Effusion vs. Pericardial Fat Pad: Background
    • Pericardial Effusion vs. Pericardial Fat Pad: IVC Inlet View
    • Echocardiographic Findings Seen With Cardiac Tamponade
    • Normal Transvalvular Inflow Velocity Respiratory Variation
    • Transvalvular Inflow Velocity with Tamponade Physiology
    • Summary: Echocardiographic Findings Supportive of Tamponade Physiology
    • Case Study: Cardiac Tamponade
  • Lesson: Procedure Preparation
    • Procedure Considerations & Supply List
    • Transducer selection & Machine Settings
    • Machine Orientation & Patient Positioning
    • Survey Scan
    • Infection Prevention Practices
    • Sterile Covers & Transducer Disinfection
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Local Anesthesia
    • Static-Image Guidance vs. Real-Time Image Guidance
    • Real-Time Image Guidance Techniques & Approaches
    • Parasternal Approach
    • Subcostal Approach
    • Apical Approach
    • Needle Aspiration vs. Catheter Drainage
    • Needle Localization
    • Case Study: PEA Arrest
  • Lesson: Technical Tips & Pitfalls
    • Tip: In-Plane Needle Guidance
    • Tip: Pericardial Effusions Vary In Echogenicity
    • Pitfall: Blind Pericardiocentesis
  • Lesson: Complications
    • Complications
  • Lesson: Summary
    • Course Summary
Ultrasound-Guided Thoracentesis: Procedure Module

Ultrasound-Guided Thoracentesis: Procedure Module

  • Lesson: Introduction
    • Disclosure to Learners
    • Disclaimer
    • Introduction to Ultrasound-Guided Thoracentesis
    • Course Overview
    • Pleural Effusion
    • Literature Review
    • Clinical Indications
    • Contraindications
    • Risk of Bleeding Complications
    • Informed Consent
  • Lesson: Regional Anatomy
    • Thorax
    • Pleural Cavity
    • Normal Lung Anatomy
    • Respiratory Dynamics
    • Dynamic Anatomy
  • Lesson: Sonographic Anatomy
    • Sonographic Characteristics
    • Hemidiaphragms
    • Pleural Effusion
    • Case Study: Small Pleural Effusion
    • Case Study: Moderate Pleural Effusion
    • Case Study: Large Pleural Effusion
    • Case Study: Pleural Effusion With Adhesions
  • Lesson: Procedure Preparation
    • General Considerations
    • Static Image Guidance
    • Real-Time Image Guidance
    • Imaging Approaches & Needle Visualization Techniques
    • Transducer Selection
    • Machine Settings
    • Machine Orientation & Positioning
    • Patient Positioning
    • Survey Scan
    • Infection Prevention Practices
    • Transducer Covers
    • Transducer Disinfection & Sterilization
  • Lesson: Procedure Steps
    • Confirm Transducer Orientation
    • Site Selection
    • Local Anesthesia
    • Thoracentesis Needle Selection
    • Principles of Thoracentesis
    • Static Image-Guided Thoracentesis
    • Real-Time Image-Guided Thoracentesis
    • Case Study: Large-Volume Pleural Effusion
    • Case Study: Exudative Pleural Effusion
    • Case Study: Limited Needle Visualization
    • Case Study: Small-Volume Pleural Effusion
    • Pleural Effusion Characterization
  • Lesson: Technical Tips & Pitfalls
    • Pitfall: Inability to Aspirate Fluid
    • Pitfall: Inability to Visualize Needle
    • Technical Tips
  • Lesson: Complications
    • Complications of Thoracentesis
    • Pneumothorax
    • Unexpandable Lung Pneumothorax
    • Lung Reexpansion Pulmonary Edema
  • Lesson: Summary
    • Course Summary

 

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