SonoDoc: Case-Based Learning in Bedside Ultrasound


Internet Enduring Material Sponsored by the Stanford University School of Medicine. Presented by the Department of Emergency Medicine at Stanford University School of Medicine

Course Description

The American Medical Association has recognized the utility of ultrasound; it recommends training and education standards are developed by each physician’s respective specialty. It has been proven that bedside ultrasound allows the treating physician to more quickly determine the cause of urgent conditions and life-threatening illness and help in guiding resuscitative efforts for patients in shock. If invasive procedures must be performed, they can be done under ultrasound guidance (instead of using blind landmark techniques), decreasing the risk of complications. This has been recommended by the agency for healthcare research and quality as a key intervention. Emergency medicine was an early adopter of bedside focused ultrasound due to the need for rapid evaluation of critically ill patients and patients in acute pain. Now, other specialty organizations, including critical care, surgery, internal medicine, OB-GYN, and pediatrics are starting to include ultrasound during residency training. Many currently practicing physicians were trained before ultrasound training was available and may not realize its utility in their practice. This game-based course will provide strategies on how to use bedside focused ultrasound, image interpretation, and integrate it in the clinical practice.

Intended Audience

This course is designed for physicians, physician assistants and nurse practitioners who specialize in family practice, primary care, general surgery, internal medicine, critical care and emergency medicine.

Dates, Duration and Fee

  • Release Date: December 7, 2018
  • Expiration Date: December 7, 2021
  • Estimated Time to Complete: 3.5 Hours
  • CME Credits Offered: 3.50
  • Registration Fees
  • CME Certificate for Physicians: $25
  • All other learners will receive a Certificate of Participation: Free

To Obtain CME Credits

  • Review the information below and complete the entire activity.
  • Complete the CME Post-test, CME Assessment Survey, and CME Activity Completion Statement at the end of the activity.
  • You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question (or one attempt for questions with only two options) to pass the post-test.
  • Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
  • Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

Learning Objectives

At the conclusion of this activity, participants should be able to:

Develop skills to screen for and diagnose emergent conditions such as tamponade, abdominal aortic aneurysm, pneumothorax, shock, ruptured ectopic pregnancy, intraperitoneal hemorrhage, acute hydronephrosis, cholecystitis, acute heart strain/failure, cellulitis, abscess, DVT, pulmonary edema, pleural effusion, retinal detachment, orbital rupture, and associated symptoms such as abdominal pain, hematuria, chest pain, shortness of breath, leg edema, skin redness, vision loss, back pain, and pelvic pain.



  1.  Introduction
  2.  Test Your Knowledge
  3.  Module 1: Bedside Ultrasound
  4.  Course Wrap-Up
  5.  Resources and References
  6.  Help!


The following planners, reviewers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity:

Laleh Gharahbaghian, MD 
Clinical Associate Professor
Medical Director, Adult Emergency Medicine
Department of Emergency Medicine 
Stanford School of Medicine
Course Director

Viveta Lobo, MD 
Clinical Assistant Professor
Director, Emergency Ultrasound Program 
Co-Director, Emergency Ultrasound Fellowship 
Department of Emergency Medicine 
Stanford School of Medicine

Sarah Williams, MD, FACEP
Clinical Associate Professor
Director of Graduate Medical Education 
Department of Emergency Medicine
Stanford School of Medicine
Program Director, Stanford/Kaiser Emergency Medicine Residency Program

Mansour Jammal, MD
Attending Physician – Emergency Medicine

Josh Ennis, MD
Staff Physician, San Francisco Emergency Medical Associates
St. Joseph Hospital, Eureka Emergency Dept

Technical Design and Development

James Laird
Two Trees Studio

Studio Cypher

David Radosevich, Nathanael Stoner and Nathaniel Brengle
Data Entry and QA

Aura Moser 
Art and User Interface

Hardware/Software Requirements

  • Computer with Internet connection
  • Current version of Chrome, Firefox or Safari browser. You must have javascript enabled.

Accreditation and Designation of Credits

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 3.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit TM from organizations accredited by the ACCME. Please check with your state’s credentialing board for their requirements.

Commercial Support Acknowledgement

Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.


Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.

CME Privacy Policy


If you are having problems, contact the CME Online support team at and we will follow-up with you to resolve your issue.


Branney SW, Wolfe RE, Moore EE, Albert NP, Heinig M, Mestek M, Eule J Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma. 1995 Aug;39(2):375-80

Diercks DB, et al American College of Emergency Physicians  Clinical policy: critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. Ann Emerg Med. 2011 Apr;57(4):387-404. doi: 10.1016/j.annemergmed.2011.01.013

Fox JC, et al  Test characteristics of focused assessment of sonography for trauma for clinically significant abdominal free fluid in pediatric blunt abdominal trauma. Acad Emerg Med. 2011 May;18(5):477-82. doi: 10.1111/j.1553-2712.2011.01071.x.

Lobo V, Daniel Weingrow D, Perera P, Williams S, Gharahbaghian L. Thoracic Ultrasonography. Critical Care Clinics. 2014; 30: 93-117.

Ma OJ, Mateer JR, Ogata M, Kefer MP, Wittmann D, Aprahamian C  Prospective analysis of a rapid trauma ultrasound examination performed by emergency physicians. J Trauma. 1995 Jun;38(6):879-85

Valentino M, De Luca C, Galloni SS, Branchini M, Modolon C, Pavlica P, Barozzi L. Contrast-enhanced US evaluation in patients with blunt abdominal trauma. J Ultrasound. 2010 Mar;13(1):22-7. doi: 10.1016/j.jus.2010.06.002. Epub 2010 Jul 8

Von Kuenssberg, Jehle D, Stiller G, et al. Sensitivity in detecting free intraperitoneal fluid with the pelvic views of the FAST exam. Am J Emerg Med 2003; 21:476-478.

Williams S, Perera P and Gharahbaghian L The FAST and E-FAST in 2013: Trauma Ultrasonography Overview, practical techniques and new frontiers. Critical Care Clinics 2014; 30: 119-150.

More bibliographic information can be found in the Resources and References section.

©2018 Stanford University School of Medicine

Course Details

  • Ongoing registration for this self-paced course is available until: December 7, 2021
  • Estimated Time to Complete: 3.5 hours
  • CME Credits Offered: 3.50
Registration Fees

CME Certificate for Physicians: $25

All other learners will receive a Certificate of Participation: Free

Contact Information

If you are having problems, contact the CME Online support team at and we will follow-up with you to resolve your issue.

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