scholarly journals Point of Care Ultrasound Use by Interns in Emergency Department

2021 ◽  
Vol 9 (E) ◽  
pp. 588-591
Author(s):  
Kamonwon Ienghong ◽  
Takaaki Suzuki ◽  
Somsak Tiamkao ◽  
Dhanu Gaysonsiri ◽  
Vajarabhongsa Bhudhisawasdi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Research Team ◽  
Emergency Services ◽  
Response Rate ◽  
Point Of Care ◽  
Daily Basis ◽  
University Hospital ◽  
Point Of Care Ultrasound ◽  
Primary Obstacle ◽  
Morning Shift

BACKGROUND: Point of care ultrasound (POCUS) is required for use in many instances on a daily basis in the hospital, especially in the emergency department and other specialty treatment areas. While interns play a crucial role in running emergency services in Thailand, the POCUS usage of interns has not been well studied. METHODS: This was a retrospective observational study of the interns who worked at the Department of Emergency Medicine, a tertiary university hospital in Khon Kaen, Thailand between July 2020 and April 2021. The seven questions survey about participants’ experiences performing POCUS examinations was conceived and carried out by the research team. The primary aim of this study is to identify the frequency of POCUS examinations performed by interns in this or any other given rotation. RESULTS: The response rate was 81.25% with the frequency of POCUS examinations per physician coming in at 2.5 per shift. It should be noted that examinations occurred primarily during the morning shift (79%) and were for diagnostic purposes (100%). The highest POCUS use cases (80%) were found to take place for abdominal examinations and the most commonly used POCUS application was the FAST (Focused Assessment with Sonography for Trauma) examination (92%). The confidence level was rated as 3/5. The primary barrier to performing POCUS was lack of knowledge or ultrasound training (47%). CONCLUSIONS: POCUS is often used by interns though less than in some other specialties. The type of POCUS application employed was limited due to lack of training and the primary obstacle for POCUS use in the emergency department was patient overcrowding.  

scholarly journals Improving the documentation quality of point-of-care ultrasound scans in the emergency department

2020 ◽  
Vol 9 (1) ◽  
pp. e000636
Author(s):  
Shadman Aziz ◽  
James Bottomley ◽  
Vasant Mohandas ◽  
Arif Ahmad ◽  
Gemma Morelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Royal College ◽  
Point Of Care ◽  
University Hospital ◽  
Point Of Care Ultrasound ◽  
Core Element ◽  
Improvement Project ◽  
Documentation Quality ◽  
Minimum Requirements

A point-of-care ultrasound scan (POCUS) is a core element of the Royal College of Emergency Medicine (RCEM) specialty training curriculum. However, POCUS documentation quality can be poor, especially in the time-pressured environment of the emergency department (ED). A survey of 10 junior ED clinicians at the Princess Royal University Hospital (PRUH) found that total POCUS documentation was as low as 38% in some examinations.This quality improvement project aimed to increase the coverage and quality of POCUS documentation in the ED. This was done by using a plan-do-study-act (PDSA) regime to improve the quality of POCUS documentation from the original baseline to 80%. There were three discreet PDSA cycles and the interventions included improving education and training about POCUS documentation and the introduction of an original proforma, which incorporated six minimum requirements for POCUS documentation as per the joint RCEM and Royal College of Radiologists (RCR) guidelines for POCUS documentation (patient details, indications, findings, conclusions, signature and date).The project team audited the quality of all documented scans in the resuscitation department of the PRUH against the RCEM/RCR guidelines at baseline and following three discrete PDSA cycles. This was done over an 8-week period, spanning 696 attendances to the resuscitation area of the ED and 42 documented POCUS examinations.Quality recording of the six RCEM/RCR elements of POCUS documentation was poor at baseline but improved following three successful PDSA cycles. There was a demonstrated improvement in five of six documentation elements: patient details on POCUS documentation increased from 53.3% to the 66.7%, indication from 60.0% to 66.7%, conclusion from 13.0% to 83.0%, signature from 86.7% to 100.0% and date from 46.7% to 66.7%.These results suggest that the introduction of a proforma and a vigorous education strategy are effective ways to improve the quality of documentation of ED POCUS.

scholarly journals One Year of Experience in Using Hand-Held Ultrasound as a Learning Tool in Ultrasound Rotation at the Emergency Department

2020 ◽  
Vol 8 (E) ◽  
pp. 674-677
Author(s):  
Kamonwon Lenghong ◽  
Korakot Apiratwarakul
Keyword(s):  
Emergency Department ◽  
Response Rate ◽  
Point Of Care ◽  
Learning Experiences ◽  
Baseline Survey ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
Video Clips ◽  
Ultrasound Technology ◽  
One Year

BACKGROUND: Recent advancements in ultrasound technology have been introduced in medical education. The use of the hand-held ultrasound device (the HHU device) has been implemented in many medical schools. However, no studies have previously been conducted in Thailand. AIM: We aimed at evaluating the experience of using the HHU device in the ultrasound rotation for the emergency medicine (EM) residents. METHODS: A survey was conducted of 1st-year EM residents at the Emergency Department at Srinagarind Hospital, who had been trained to use point-of-care ultrasound and who were provided with a HHU device during their 2-week ultrasound rotation during the period from July 2019 to June 2020. The survey consisted of ten questions about the participants’ learning experiences in using the HHU. Moreover, we evaluate the process of reviewing the ultrasound images and ultrasound video clips from the HHU device. RESULTS: The response rate for the survey was 100%. On the baseline survey, most participants rated their learning experiences in using the HHU device at more than four points. Overall, 106 patients were examined with the HHU device. All ultrasound video clips and images were examined in the section for “reviewing the ultrasound images.” The three areas that were the most frequently examined had been the abdomen, the heart, and the soft tissue and musculoskeletal, respectively. During these ultrasound examinations, 82 positive findings (77.36%) were discovered. CONCLUSIONS: These results suggest that the participants had agreed that the HHU device was a tool, which had the potential to promote learning during the ultrasound rotation.

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

POCUS Journal ◽  
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.

scholarly journals 145 Point of care lung ultrasound in patient triage: integration of ultrasound into a streaming pathway for COVID-19

2020 ◽  
Vol 37 (12) ◽  
pp. 839.1-839
Author(s):  
Dominic Craver ◽  
Aminah Ahmad ◽  
Anna Colclough
Keyword(s):  
Point Of Care ◽  
District General Hospital ◽  
Training Programme ◽  
Service Evaluation ◽  
University Hospital ◽  
Junior Doctors ◽  
Point Of Care Ultrasound ◽  
Face To Face ◽  
Point Of Care Diagnostics ◽  
Audit Data

Aims/Objectives/BackgroundRapid risk stratification of patients is vital for Emergency Department (ED) streaming during the COVID-19 pandemic. Ideally, patients should be split into red (suspected/confirmed COVID-19) and green (non COVID-19) zones in order to minimise the risk of patient-to-patient and patient-to-staff transmission. A robust yet rapid streaming system combining clinician impression with point-of-care diagnostics is therefore necessary.Point of care ultrasound (POCUS) findings in COVID-19 have been shown to correlate well with computed tomography (CT) findings, and it therefore has value as a front-door diagnostic tool. At University Hospital Lewisham (a district general hospital in south London), we recognised the value of early POCUS and its potential for use in patient streaming.Methods/DesignWe developed a training programme, ‘POCUS for COVID’ and subsequently integrated POCUS into streaming of our ED patients. The training involved Zoom lectures, a face to face practical, a 10 scan sign off process followed by a final triggered assessment. Patient outcomes were reviewed in conjunction with their scan reports.Results/ConclusionsCurrently, we have 21 ED junior doctors performing ultrasound scans independently, and all patients presenting to our department are scanned either in triage or in the ambulance. A combination of clinical judgement and scan findings are used to stream the patient to an appropriate area.Service evaluation with analysis of audit data has found our streaming to be 94% sensitive and 79% specific as an indicator of COVID 19. Further analysis is ongoing.Here we present both the structure of our training programme and our integrated streaming pathway along with preliminary analysis results.

scholarly journals Female with Vaginal Bleeding

2020 ◽  
Vol 4 (4) ◽  
pp. 636-637
Author(s):  
Mark Quilon ◽  
Alec Glucksman ◽  
Gregory Emmanuel ◽  
Josh Greenstein ◽  
Barry Hahn
Keyword(s):  
Emergency Department ◽  
Emergency Physician ◽  
Vaginal Bleeding ◽  
Point Of Care ◽  
First Trimester ◽  
Yolk Sac ◽  
Pregnant Female ◽  
Point Of Care Ultrasound ◽  
Fetal Demise ◽  
Case Presentation

Case Presentation: A 24-year-old pregnant female presented to the emergency department with lower abdominal cramping and vaginal bleeding. A point-of-care ultrasound demonstrated a calcified yolk sac. Discussion: When identified, calcification of the yolk sac in the first trimester is a sign of fetal demise. It is important for an emergency physician to be aware of the various signs and findings on point-of-care ultrasound and be familiar with the management of these pathologies.

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