Ambulatory Use of Handheld Point-of-Care Ultrasound (HH-POCUS) in Rural Brandenburg – A Pilot Study

2021 ◽  
Author(s):  
Hendra Lo ◽  
Vilmar Frauendorf ◽  
Sandra Wischke ◽  
Christin Schimmath-Deutrich ◽  
Markus Kersten ◽  
...  
Keyword(s):  
Palliative Care ◽  
Rural Areas ◽  
Point Of Care ◽  
Data Entry ◽  
Relevant Information ◽  
Therapeutic Interventions ◽  
Point Of Care Ultrasound ◽  
Catheter Position ◽  
Data Entry Form ◽  
Transurethral Catheter

Abstract Purpose This study aims to evaluate the use of handheld ultrasound devices (HHUS) for point-of-care ultrasound (POCUS) to improve outpatient care in rural Brandenburg. Materials and Methods A group of general practitioners (n = 9), palliative care physicians (n = 6), emergency physicians (n = 4), and nurses from palliative care services (n = 5) participated in this study. Following a 3-hour workshop and 2 weeks of individual training, participants performed POCUS using HHUS (HH-POCUS). Indications, examination results, and resulting treatment changes (e. g., acute interventions, new medication) were documented in a standardized data entry form. Results 19 physicians with different ultrasound experience and 5 palliative care nurses attended the workshop program and took part in the study. Three of the participating physicians were out of training in ultrasound and received prolonged supervision. Among 427 HH-POCUS examinations, the FAST scan and kidney scan were performed most often. Pain and dyspnea were the most common indications for HH-POCUS. Among the examinations performed by physicians (n = 311), ascites was the most common pathology (27 % of cases). Using a simplified examination protocol, palliative care nurses diagnosed fluid collections, hydronephrosis and transurethral catheter position or urinary retention. In 80.4 % of physician-performed cases, HH-POCUS made a valuable impact on patient management. HH-POCUS contributed to treatment decisions in 49.5 % of cases, including a change of medication in 29.6 % and performance of therapeutic interventions in 19.9 %. Hospital admission or referral to an ambulatory specialist was initiated due to HH-POCUS findings in 17.7 % of patients. Conclusion HH-POCUS helped doctors in rural areas to optimize patient care through rapid on-site collection of therapeutically relevant findings. In addition, it was shown that specialized and motivated nurses can independently detect simple ultrasound findings and thus provide clinically relevant information to doctors.

scholarly journals Utility of point-of-care ultrasound in the pediatric intensive care unit

2019 ◽  
Author(s):  
Reagan Lyman ◽  
Yoshikazu Yamaguchi ◽  
Alok Moharir ◽  
Alok Moharir ◽  
Joseph D. Tobias
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Point Of Care ◽  
Pediatric Intensive Care ◽  
Therapeutic Interventions ◽  
Point Of Care Ultrasound ◽  
Critical Care Units ◽  
Clinical Scenarios

For critically ill patients, point-of-care ultrasound (POCUS) has been rapidly adopted for use in emergency departments and critical care units for diagnostic purposes and to guide decision making. We present two unique clinical scenarios in the Pediatric Intensive Care Unit (PICU), one in which ultrasound was used as a diagnostic tool to identify pulmonary edema, and the other in which ultrasound was used to facilitate placement of a naso-duodenal tube for enteral feeding. The potential role of POCUS in the PICU is presented and its utility in these two unique clinical scenarios discussed. Although, many cases will still require further radiological tests, The success of POCUS lies in immediate diagnosis allowing at the spot therapeutic interventions without wasting precious time.Citation: Lyman R, Yamaguchi Y, Moharir A, Tobias JD. Utility of point-of-care ultrasound in the pediatric intensive care unit. Anaesth pain & intensive care 2019;23(3):314-317

Research: Does the Addition of Ultrasound Enhance Cardiac Anatomy Learning in Undergraduate Medical Education?

POCUS Journal ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 7-8 ◽  
Author(s):  
Joshua Durbin, MD ◽  
Amer M. Johri, MD ◽  
Anthony Sanfilippo, MD
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Point Of Care ◽  
Therapeutic Interventions ◽  
First Year ◽  
Point Of Care Ultrasound ◽  
Cardiac Anatomy ◽  
True Value ◽  
Queen's University ◽  
First Year Medical Students

With the advent of portable hand-held ultrasound units, the use of point of care ultrasound (POCUS) has become increasingly popular amongst a wide array of medical specialists for both diagnostic and therapeutic interventions. Canada-wide surveys demonstrate a desire for increased utilization of POCUS in primary medical education. In this study, we aim to assess the efficacy of an ultrasound based anatomy tutorial and the perspectives of a cohort of first year medical students at Queen’s University. Students were recruited, randomized to pre or post-test analysis, and provided with a supplementary lecture on cardiac anatomy utilizing echocardiography studies. In this study, we were unable to demonstrate a difference between understanding of basic cardiac anatomy between groups. However, we were able to report the opinions and perspectives of a small cohort of first year medical students at Queen’s University, illustrating a desire for increased exposure and training towards cardiac POCUS in primary medical education. Further evidence is required to delineate the true value of these experiences.

Use of ultrasound in the antenatal space

2021 ◽  
Vol 29 (7) ◽  
pp. 370-374
Author(s):  
Shashikant L Sholapurkar ◽  
Stephen O'Brien ◽  
Joanne Ficquet
Keyword(s):  
Rural Areas ◽  
Point Of Care ◽  
Emotional Experience ◽  
Image Transmission ◽  
Point Of Care Ultrasound ◽  
Medical Ultrasound ◽  
Rapid Progress ◽  
Growing Domain ◽  
Ultrasound Technology

The first practical medical ultrasound machine was pioneered in the antenatal practice. Next, the rapid progress in the antenatal care and research demanded/propelled major advances in ultrasound technology and vice versa. Today, ultrasonography has become a part of pregnancy journey, emotional experience and bonding. Affordable pocket-sized ultrasound scanners and remote image transmission technology hold a new promise in rural areas. Point-of-care ultrasound by midwives for fetal growth and wellbeing is a growing domain. This article discusses current challenges and potential developments pertaining to the role of ultrasound in the first, second and third trimesters of pregnancy in different resource settings.

Ultrasound application in point of care by palliative medicine physicians: Initial experience of oncology palliative medicine consultation in two rural area hospitals in Costa Rica.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 254-254
Author(s):  
Karol Villalobos
Keyword(s):  
Costa Rica ◽  
Rural Areas ◽  
Palliative Medicine ◽  
Point Of Care ◽  
Limited Resources ◽  
Point Of Care Ultrasound ◽  
Resource Limited Settings ◽  
Portable Ultrasound ◽  
Resource Limited ◽  
Point Of Care Ultrasonography

254 Background: Point of care Ultrasonography (POCUS)—that is ultrasonography performed and interpreted by the clinician at the bedside—is a method of clinical focused evaluation assisted by ultrasound equipment which gives the health provider in limited resources conditions, a prompt and accurate diagnosis for a limited number of pathologies. Development of portable ultrasound equipment with accessible technologies in terms of health investment, allows developing such practice in non-conventional resource-limited settings as patient homes. Our proposal is to show point of care ultrasonography (POCUS) experiences by two Palliative Care specialist doctors with in government-managed Social Security service (CCSS) in rural areas in Costa Rica. Methods: Limited diagnosis examinations were performed both at the hospital as well as at out of hospital sites in rural areas of Turrialba, and San Carlos, Costa Rica. Percutaneous procedures took place at the hospital following monitoring and aseptic standards, using two different units (Contec CMS600P2B, Phillips Clearvue 550). Results: Each brief case presented in this article shows effective Point of Care Ultrasound uses for patients with life-limiting conditions in resource-limited settings. Use of this technology by palliative medicine specialists in these cases helped patients and their families by accelerating right diagnosis, limiting unnecessary hospital transportation or by helping making safer procedures. Conclusions: Point of care ultrasound usage by palliative medicine specialists is an innovation breaking paradigms that has shown in our case to be a successful help as an evaluation strategy in a limited-resources rural environment, with a frail population.

scholarly journals Current Practices in Central Venous Catheter Position Confirmation by Point of Care Ultrasound

Shock ◽  
2019 ◽  
Vol 51 (5) ◽  
pp. 613-618 ◽  
Author(s):  
Enyo A. Ablordeppey ◽  
Anne M. Drewry ◽  
Daniel L. Theodoro ◽  
LinLin Tian ◽  
Brian M. Fuller ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Point Of Care ◽  
Venous Catheter ◽  
Point Of Care Ultrasound ◽  
Central Venous ◽  
Catheter Position ◽  
Current Practices

scholarly journals MP43: Evaluation of undergraduate point of care ultrasound instruction in a rural Canadian medical school

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S58
Author(s):  
Z. Kuehner ◽  
M. Dmitriew ◽  
M. Jefkins ◽  
B. Piper ◽  
S. Byce ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Rural Areas ◽  
Clinical Medicine ◽  
Point Of Care ◽  
Ct Scans ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Northern Ontario ◽  
Canadian Medical School ◽  
Before And After

Introduction: Point of care ultrasound is a burgeoning tool in clinical medicine and its utility has been demonstrated in a variety of contexts. It may be especially useful in rural areas where access to other imaging equipment (such as CT) is limited. However, there exists debate about the utility of teaching ultrasound theory and technique to medical undergraduates, particularly those in their first two years of study. This study evaluated the efficacy of teaching undergraduate-tailored ultrasound training sessions to first and second-year medical students at the Northern Ontario School of Medicine (NOSM), a rural-focused medical institution. Methods: Sixty students participated in tailored ultrasound teaching sessions that involved both lecture and hands-on components. Participating students were assessed following each session, as well as at study completion, in terms of ultrasound knowledge, anatomy, pathology, orientation, and interpretation of computerized tomography (CT) scans (transferability). Participants’ performance was measured against a control group of their peers. Program evaluation was completed using Likert-type scales to determine participant comfort with ultrasound before and after the training, and areas of strength and improvement. Results: Participating students showed statistically significant improvement in ultrasound interpretation and anatomical orientation with trends toward improved anatomy and pathology knowledge, and ability to interpret computerized tomography (CT) scans compared to controls. Students participating in the course expressed improved comfort with ultrasound techniques and desire for future integration of ultrasound into their training, but noted that increasing frequency of training sessions might have improved retention and confidence. Conclusion: Results suggest that using an undergraduate-focused and system-specific ultrasound training course yields retention in ultrasound interpretation ability and objective improvement in relational anatomy knowledge. Trends toward improvement in general anatomy, pathology and CT interpretation suggest areas of future study.

Utilization of POCUS in a Specialist Palliative Care Setting: A Retrospective Chart Review.

2020 ◽  
Author(s):  
Amit Arya ◽  
John Roderick Davey ◽  
Achal Sharma ◽  
Naheed Dosani ◽  
Dilnoor Grewal ◽  
...  
Keyword(s):  
Palliative Care ◽  
Chart Review ◽  
Care Setting ◽  
Point Of Care ◽  
Symptom Burden ◽  
Retrospective Chart Review ◽  
Care Utilization ◽  
Point Of Care Ultrasound ◽  
Specialist Palliative Care ◽  
Palliative Care Setting

Abstract Background: The use of Point-Of-Care Ultrasound (POCUS) has increased rapidly across various medical disciplines due to technological advancements providing high quality POCUS units. POCUS can help clinicians at the bed side with information regarding patient management in real time. However, literature reveals scant evidence of POCUS use in Palliative Care. This study’s objective was to examine the use of POCUS in a specialist palliative care setting. Methods: A retrospective chart review was conducted from January 2018 to June 2019 to evaluate characteristics of patients for whom POCUS was utilized. These patients were identified through pre-existing logs and descriptive information was collected from the electronic health records. This included demographic information, life-limiting diagnosis, patient assessment location, diagnosis made with POCUS and, if applicable, volume of fluid drained.Results: We identified 126 uses of POCUS in 89 unique patients. 62 patients (69.7%) had a cancer diagnosis, with patients most commonly suffering from GI, Lung and Breast pathologies. 61 POCUS cases (48.4%) were in the outpatient setting. 81 POCUS cases (64.3%) revealed a diagnosis of ascites and 21 POCUS cases (16.7%) revealed a diagnosis of pleural effusion. Other diagnoses made with POCUS included bowel obstruction, pneumonia and congestive heart failure. During the study period, 52 paracentesis and 7 thoracentesis procedures were performed using POCUS guidance.Conclusion: We identified multiple indications in our specialist palliative care setting where POCUS aided in diagnosis/management of patients in both inpatient and outpatient settings. Further studies can be conducted to identify the potential benefits in symptom burden, patient & caregiver satisfaction and health care utilization in palliative care patients receiving POCUS.

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