scholarly journals Application of Point-of-Care Ultrasound for Family Medicine Physicians for Abdominopelvic and Soft Tissue Assessment

Cureus ◽  
2020 ◽  
Author(s):  
Sarah E Frasure ◽  
Elizabeth Dearing ◽  
Morgan Burke ◽  
Maria Portela ◽  
Ali Pourmand
Keyword(s):  
Soft Tissue ◽  
Family Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound

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.

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 ◽  
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.

scholarly journals Outcome of Pediatric Emergency Point-of-Care Ultrasound (POCUS) for Management of Skin and Soft Tissue Infection Prior to Ultrasound Program Implementation

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Whitney Phillips, BS ◽  
Benjamin Nti, MD, MSc
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Program Implementation ◽  
Point Of Care ◽  
International Classification Of Diseases ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Implementation Period ◽  
Classification Of Diseases

Background and Hypothesis: Point-of-care ultrasound (POCUS) is underutilized for evaluation of skin and soft tissue infections (SSTI) in the pediatric emergency department (ED). This study seeks to determine the utilization of POCUS compared to formal radiology ultrasound for SSTI in the pediatric ED prior to an ultrasound program implementation. We hypothesize that POCUS utilization will be low but can lead to a decreased length of stay (LOS) and cost for patients with SSTI.  Experimental Design or Project Methods: This is a retrospective EMR chart review covering pre-implementation (July 2016-June 2017) and post-implementation (July 2018-June 2019) of a POCUS program curriculum. Patients (<18 years old) were included based on screening for diagnoses via the international classification of diseases 9th and 10th revision codes for abscesses and cellulitis. We excluded patients who required admission and subspecialty consult or had other non-SSTI evaluation.   Results: Pre-Implementation period included 160 patients who met inclusion and exclusion criteria. Of these, 16 (10%) received POCUS evaluation and 8 (5%) received a radiology image evaluation. The majority of patients had cellulitis (80%) when compared to abscess (20%). The average LOS for POCUS ultrasound was 173 minutes compared to 304 minutes for radiology evaluation. The total cost for visit was $3,503 for patients evaluated by POCUS compared to $8,875.56 for patients who received radiology imaging.  Conclusion and Potential Impact: Taken together, the pre-implementation assessment of POCUS utilization in the pediatric emergency department was low but associated with decreased LOS and lower total ED cost when applied to SSTI management.

scholarly journals Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department

2020 ◽  
Author(s):  
Wei-Lung Chen ◽  
Chan-Peng Hsu ◽  
Po-Han Wu ◽  
Jiann-Hwa Chen ◽  
Chien-Cheng Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Training Program ◽  
Test Score ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Studies ◽  
Training Course ◽  
Hemodynamic Assessment ◽  
Procedural Guidance

Abstract Background: Point-of-care ultrasonography (POCUS) is a prompt and simple tool for the urgent diagnosis and treatment of patients in the emergency department (ED). It has contributed to improvements in patient treatment quality, procedural safety, timeliness of care, diagnostic accuracy, and cost reduction. We developed a comprehensive residency-based POCUS training program for ED residents and determined its effect on ultrasound utilization in the ED.Methods: We conducted a retrospective cohort study in the ED of a university-affiliated medical center, evaluating a centralized residency-based POCUS training course from July 2017 to June 2018 for ED residents that included 12 core ultrasound applications: trauma, intrauterine pregnancy, abdominal aortic aneurysm, echocardiography and hemodynamic assessment, hepatobiliary system, urinary tract, deep vein thrombosis, soft tissue and musculoskeletal, thoracic-airway, ocular, bowel, and procedural guidance. Each application comprised a combined lecture and hands-on practice session that lasted for 2 hours. Pre-tests and post-tests, including still image and video interpretation, were performed. Utilization of POCUS among ED residents before and after the POCUS training course (July 2016–June 2017 and July 2018–June 2019) was calculated and analyzed using the Wilcoxon signed-rank test.Results: In total, 16 residents participated and completed the entire training course. The post-test score improved significantly compared to the pre-test score by a median of 12 points (p = 0.04). Utilization of POCUS among the ED residents increased significantly from 0.15 ultrasound studies per patient per year to 0.41 ultrasound studies per patient per year (p < 0.01) after completion of the entire training course. Increased POCUS scanning percentages over the cardiac, soft tissue, abdominal region, vascular system, procedural guidance, and ocular regions were also noted after providing the curriculum.Conclusions: There was a significant increase in POCUS utilization among ED residents after a comprehensive residency-based POCUS training program.

scholarly journals Considerations for Implementing Point-of-Care Ultrasound in a Community-Based Family Medicine Residency Program

2019 ◽  
Vol 6 ◽  
pp. 238212051988432
Author(s):  
Megan Weemer ◽  
Matt Hutchins ◽  
Eric Beachy ◽  
Nicole McGuire
Keyword(s):  
Family Medicine ◽  
Residency Program ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Family Medicine Residency ◽  
Vein Thrombosis ◽  
Recent Graduates ◽  
Barriers To Implementation ◽  
Procedural Guidance ◽  
Deep Vein

Background: Prior to implementing Point-of-Care Ultrasound (POCUS) training into our Family Medicine Residency Program, we sought to determine opinions on the most relevant applications according to current Family Medicine residents and recent graduates. As there are so many POCUS applications relevant to Family Medicine, it would be efficient to teach only the most relevant scans. Objective: Examine current POCUS use and the perception of future use among current residents and recent graduates of a Family Medicine Residency Program. Methods: In 2017, an electronic survey was used to examine differences in perceptions regarding the value of POCUS applications, benefits of use, and potential barriers to implementation. Results: Of the 88 surveys sent, 21 of 21 current residents (100%) and 28 of 67 recent graduates (41.8%) completed the survey with a total completion rate of 55.7%. The POCUS practices differed between groups. Current residents were significantly more likely than recent graduates to use POCUS for vascular procedural guidance and other procedural guidance. Recent graduates were significantly more likely to report POCUS use for abdominal aortic aneurysm screening and lower extremity Doppler screening for deep vein thrombosis. All P values were significant at the .05 level. Conclusions: Point-of-Care Ultrasound training is generally desired by current residents. Some applications are perceived to be of sufficient utility by current residents and recent graduates. Findings would justify investment of time and effort required to implement POCUS training in Family Medicine Residency curriculums. Curriculum should focus on applications viewed as high priority based on usage rates.

scholarly journals Experience of Snakebite Envenomation by a Desert Viper in Qatar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Amr Elmoheen ◽  
Waleed Awad Salem ◽  
Mahmoud Haddad ◽  
Khalid Bashir ◽  
Stephen H Thomas
Keyword(s):  
Soft Tissue ◽  
Early Diagnosis ◽  
Review Paper ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Bleeding Diathesis ◽  
Clotting Factors ◽  
Systemic Complications ◽  
The World ◽  
Soft Tissue Problems

Crotaline and elapid snakebites are reported all over the world as well as in the Middle East and other countries around this region. However, data regarding snakebites and their treatment in Qatar are limited. This review paper is going to investigate the presentation and treatment of snakebite in Qatar. A good assessment helps to decide on the management of the snakebites envenomation. Antivenom and conservative management are the mainstays of treatment for crotaline snakebite. Point-of-care ultrasound (POCUS) has been suggested to do early diagnosis and treatment of soft tissue problems, such as edema and compartment syndrome, after a snakebite. The supporting data are not sufficient regarding the efficiency of POCUS in diagnosing the extent and severity of tissue involvement and its ultimate effect on the outcome. Further research is suggested in this case. Systemic complications, such as bleeding diathesis, can be managed by administering clotting factors and platelets.

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