Diagnostic Imaging: Point-of-Care Ultrasound

Background: Nearly half of the world lacks access to diagnostic imaging. Point of care ultrasound (POCUS) is a versatile and relatively affordable imaging modality that offers promise as a means of bridging the radiology gap and improving care in low resource settings. Methods: We performed semi-structured interviews of key stakeholders at two diverse hospitals where POCUS implementation programs had recently been conducted: one in a rural private hospital in Haiti and the other in a public referral hospital in Malawi. Questions regarding the clinical utility of POCUS, as well as barriers and facilitators of its implementation, were asked of study participants. Using the Framework Method, analysis of interview transcripts was guided by the WHO ASSURED criteria for point of care diagnostics. Results: Fifteen stakeholders with diverse roles in POCUS implementation were interviewed. Interviewees from both sites considered POCUS a valuable diagnostic tool that improved clinical decisions. They perceived barriers to adequate training as one of the most important remaining barriers to POCUS implementation. Conclusions: In spite of the increasing affordability and portability of ultrasounds devices, there are still important barriers to the implementation of POCUS in resource-limited settings.

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Point-of-care Transperineal Ultrasound to Diagnose Abscess in the Emergency Department

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.6.43514 ◽

2019 ◽

Vol 3 (4) ◽

pp. 349-353 ◽

Cited By ~ 1

Author(s):

Hamid Shokoohi ◽

Matthew Pyle ◽

Sarah Frasure ◽

Ubah Dimbil ◽

Ali Pourmand

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Diagnostic Imaging ◽

Imaging Modality ◽

Point Of Care ◽

Transperineal Ultrasound ◽

Point Of Care Ultrasound ◽

Ultrasound Technique ◽

Rectal Pain ◽

Optimal Imaging

Perineal and rectal pain are common presentations in the emergency department (ED). In the majority of cases, clinical examination is sufficient to detect local anorectal pathologies. However, perianal and rectal abscesses and fistulas are often the primary concerns prompting diagnostic imaging in the ED. Currently, computed tomography is the preferred imaging modality. Recently, transperineal ultrasound has emerged as an optimal imaging modality for the diagnosis of perineal and perianal abscesses. We present a case in which point-of-care ultrasound accurately detected an intersphincteric abscess, and review the appropriate ultrasound technique to evaluate patients with suspected perianal and rectal abscesses.

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Evaluation of Diagnostic Imaging Capacity and the Role for Point-of-Care Ultrasound (POCUS) within the Zanzibar Health System

POCUS Journal ◽

10.24908/pocus.v6i1.14763 ◽

2021 ◽

Vol 6 (1) ◽

pp. 45-50

Author(s):

Abiola A. Fasina ◽

Anthony J. Dean ◽

Nova L. Panebianco ◽

Frances S. Shofer ◽

Omar Ali ◽

...

Keyword(s):

Diagnostic Imaging ◽

Needs Assessment ◽

Health Care Providers ◽

Point Of Care ◽

Public Hospitals ◽

Point Of Care Ultrasound ◽

Care Providers ◽

Ct Scanner ◽

Convenience Sample ◽

High Level

Background: The Zanzibar Ministry of Health identified access to ultrasound (US) as a system priority due to limited diagnostic imaging capacity and consequent impact on patient care and requested a needs assessment in this regard. As a result, the objective of this study was to assess diagnostic imaging capacity focusing on ultrasound in Zanzibar, including health care providers’ (HCPs) current training, use, and barriers to implementation. Methods: A previously published ultrasound needs assessment survey was modified and administered on-site at the eight public hospitals in Zanzibar among a convenience sample of HCPs. Demographics, perceived US needs, current training and practice, and availability of specialty support were assessed. HCPs also completed focused personal interviews (FPIs) to explore experience with training, interests, and barriers to ultrasound. On-site diagnostic imaging modalities were assessed. Results: There were nine ultrasound machines present at six of the eight public hospitals assessed. All had x-ray, but only one had a CT scanner and a radiologist. There was no MRI capacity at the hospitals assessed at the time of the study. Survey data among 40 participants revealed that prior experience with POCUS was limited with only 10% reporting any prior ultrasound training or experience. The majority of those surveyed (72%), indicated a ‘high’ interest in learning ultrasound. Of those reporting interest in POCUS applications, obstetrics was the most often cited (70%). Lack of ultrasound machines (40%) and educators (28%) were identified as the greatest barriers. Conclusion: HCPs in Zanzibar have limited access to diagnostic imaging, including ultrasound, and expressed a high level of interest in learning point-of-care ultrasound. A shortage of machines and educators are the main barriers to widespread use. Obstetrics is the application for which ultrasound is currently most used and is the application HCPs are most interested in learning. Equipment and educational support for a POCUS program could improve care by increasing access to diagnostic imaging.

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Clinical applications of the venous excess ultrasound (VExUS) score: conceptual review and case series

The Ultrasound Journal ◽

10.1186/s13089-021-00232-8 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Philippe Rola ◽

Francisco Miralles-Aguiar ◽

Eduardo Argaiz ◽

William Beaubien-Souligny ◽

Korbin Haycock ◽

...

Keyword(s):

Diagnostic Imaging ◽

Physical Examination ◽

Point Of Care ◽

Case Series ◽

Clinical Applications ◽

Right Ventricular Failure ◽

Point Of Care Ultrasound ◽

Clinical Tool ◽

Ventricular Failure ◽

Ultrasound Score

AbstractThe importance of functional right ventricular failure and resultant splanchnic venous congestion has long been under-appreciated and is difficult to assess by traditional physical examination and standard diagnostic imaging. The recent development of the venous excess ultrasound score (VExUS) and growth of point-of-care ultrasound in the last decade has made for a potentially very useful clinical tool. We review the rationale for its use in several pathologies and illustrate with several clinical cases where VExUS was pivotal in clinical management.

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Accuracy of Point-of-Care Ultrasound for Diagnosis of Skull Fractures in Children

PEDIATRICS ◽

10.1542/peds.2012-3921d ◽

2013 ◽

Vol 131 (6) ◽

pp. X22-X22

Keyword(s):

Point Of Care ◽

Point Of Care Ultrasound ◽

Skull Fractures ◽

Fractures In Children

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Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽

10.24908/pocus.v3i1.13310 ◽

2018 ◽

Vol 3 (1) ◽

pp. 13-14

Author(s):

Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽

Maryam Al Ali, MBBS

Keyword(s):

Emergency Department ◽

Critical Care ◽

Case Report ◽

Soft Tissue ◽

Necrotizing Fasciitis ◽

Soft Tissue Infection ◽

Critical Care Unit ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

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Pilot Project: Does formal bedside training of medical students with a FAST exam increase their knowledge and comfort level with ultrasound use in a community family medicine practice setting?

POCUS Journal ◽

10.24908/pocus.v2i2.13279 ◽

2017 ◽

Vol 2 (2) ◽

pp. 15-17

Author(s):

Rimi Sambi, MD ◽

Heather Sawula, MD ◽

Brent Wolfrom, MD ◽

Joseph Newbigging, MD

Keyword(s):

Medical Students ◽

Family Medicine ◽

Point Of Care ◽

Training Session ◽

Undergraduate Curriculum ◽

Knowledge Retention ◽

Comfort Level ◽

Point Of Care Ultrasound ◽

Medical Undergraduate ◽

Fast Exam

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.

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