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The Hybrid POCUS-to-Echo Feasibility Study: Provision of Expedited Cardiac Point of Care Ultrasound Service (e-POCUS) by the Echocardiography Lab

Hanane Benbarkat, MD; Tony Sanfilippo, MD; Jian Zhang, RDCS; Amer M. Johri, MD MSc FRCPC FASE – Comprehensive transthoracic echocardiography (CTE) provides information vital to the care of acutely ill and unstable patients, but may not be readily available. Cardiac point of care ultrasound (POCUS) is well suited to providing key information at the bedside to expedite decision making. Our objective was to evaluate the feasibility of expedited-POCUS (e-POCUS) provided by the echo lab for internal medicine, cardiology and intensive care services.

The Master Clinician’s Elective: Integrating Evidence-Based Physical Examination and Point of Care Ultrasonography in Modern Clinical Medicine

Maria Gabriela Frank MD; Cason Pierce MD; Noelle Northcutt MD; Joseph Walker Keach MD; Gerard Salame MD; Rebecca Allyn MD – Many internal medicine residency programs have incorporated ultrasonography into their curriculum; however, its integration with physical examination skills teaching at a graduate medical level is scarce. The program’s aim is to create a reproducible elective that combines physical exam and bedside ultrasound as a method for augmenting residents’ knowledge and competence in these techniques with the ultimate goal of improving patient care.

Demonstration of a Longitudinal Medical Education Model (LMEM) Model to Teach Point-of-Care Ultrasound in Resource-Limited Settings

Michael Yao; Lauren Uhr; George Daghlian; Junedh M. Amrute; Ramya Deshpande; Benji Mathews, MD; Sanjay A. Patel, MD; Ricardo Henri, MD; Gigi Liu, MD; Kreegan Reierson, MD; Gordon Johnson, MD –
Short-term medical missions prevail as the most common form of international medical volunteerism, but they are ill-suited for medical education and training local providers in resource-limited settings. Objective: The purpose of this study is to evaluate the effectiveness of a longitudinal educational program in training clinicians how to perform point-of-care ultrasound (POCUS) in resource-limited clinics. Design: A retrospective study of a four-month POCUS training program was conducted with clinicians from a rural hospital in Haiti. The model included one-on-one, in-person POCUS teaching sessions by volunteer instructors from the United States and Europe. The Haitian trainees were assessed at the start of the program and at its conclusion by a direct objective structured clinical examination (OSCE), administered by the visiting instructors, with similar pre- and post- program ultrasound competency assessments.

Can the Use of Bedside Lung Ultrasound Reduce Transmission Rates in The Case of The COVID-19 Patient? – A Narrative Review

Sheena Bhimji-Hewitt MAppSc; DMS, CRGS, RDMS – Novel Corona Virus Disease-19 (nCov-19, COVID-19) was recognised as a pandemic by the World Health Organization on March 11, 2020. As of June 14, 2020, this contagious viral disease has afflicted 188 out of 195 countries in the world with 7,893,700 confirmed cases and 432,922 global deaths.Canada has 98,787 people infected and 8,146 deaths. COVID-19 is thought to transmit through contact, droplets and aerosolization. A rapid review showed limited information on the benefits of conducting lung ultrasound (LUS) versus chest radiograph (CXR) or studies correlating lung ultrasound to chest computed Tomography (CT) in patients positive for Covid-19.

Shedding light on a hidden source of septic shock with POCUS

by Miguel Lourenço Varela; Rita Martins Fernandes; Maria Luísa Melão; Javier Moreno; Cristina Granja –
A 77-year old male was admitted in the emergency department for septic shock, yet no clear source of infection was noted upon physical examination and a portable chest x-ray. Due to his unstable condition, bedside ultrasound was performed. A heterogeneous mass in the liver was noted, hence a tentative diagnosis of liver abscess was made. This was latter confirmed by abdominal computed tomography. This case highlights that point-of-care ultrasound, when performed by expert physicians, can significantly decrease time to diagnosis for septic patients.

Postpartum Hemorrhage Emergency Management Using Focused Assessment With Sonography For Obstetrics (FASO): A Case Report

by C. Rincón ; J. Cubillos; C. Arzola –
Postpartum hemorrhage is the leading cause of maternal death around the world according to World Health Organization [1]. While cesarean delivery is a risk factor, uterine atony is the main etiology [2]. Cesarean delivery and concomitant tubal sterilization are a known risk of postoperative intra-abdominal bleeding, which can be insidious and difficult to diagnose in the recovery period. Furthermore, a late diagnosis can lead to a less than optimal management. Point-of-care ultrasonography is an available technique that can contribute to a prompt diagnosis and accurate decision-making [3]. We present a case of a patient in postoperative care after cesarean delivery and tubal sterilization who developed hypovolemic shock symptoms, without any sign of uterine atony or vaginal bleeding. Focused assessment with sonography for obstetrics (FASO) was quickly performed in the recovery room to diagnose intra-abdominal bleeding and decision-making to perform an emergency surgical intervention.

Perceived Barriers and Facilitators to the use of Point-of-Care Ultrasound for Clinicians in Oregon

by Camellia Dalai; Renee K. Dversdal –
The use of Point-of-Care Ultrasound (POCUS) to provide clinical data beyond the history and physical examination is a relatively new practice for primary care providers and hospitalists. It takes many hours of dedicated ultrasound (US) training and practice to achieve POCUS proficiency; further, perceptions and attitudes of clinicians play a major role in adopting POCUS into daily clinical repertoire.

Point-of-Care Ultrasound Training for Family Medicine Residents: Examining the outcomes and feasibility of a pilot ultrasound curriculum

by Gordon Yao; Taeyoung Peter Hong; Philip Lee; Joseph Newbigging; Brent Wolfrom –
It is estimated that 50% of deaths due to abdominal aortic aneurysms (AAA) could be prevented by a national screening program. Thanks to technological ad­vancements and cost reductions, point-of-care ultrasound (POCUS) in family medicine (FM) is becoming more prev­alent [4, 5]. Despite the potential utility of POCUS in FM, of 224 FM residency programs surveyed, only 21% had developed a curriculum.

Minding the Gap(s): Hospitalists Experience Aspirational, Safety, and Knowledge Deficits That Prevent Them From Practicing POCUS

by Stephanie Conner; David Chia; Farhan Lalani; Meghan O’Brien; James Anstey; Nima Afshar; Trevor Jensen –
Point-of-care ultrasound (POCUS) has been a mainstay of clinical decision-making in the intensive care unit and emergency department for more than a decade, but adoption into hospital medicine has lagged behind. Recently, internal medicine residency programs have started to develop POCUS curricula for trainees, though concurrent hospitalist training programs have been limited to date, with little consensus on what hospitalist-oriented curricula should entail. As such, there is wide variability amongst hospitalists with respect to utilization of, training in, and proficiency in POCUS.

Simulator-Based Training in FoCUS with Skill-Based Metrics for Feedback: An Efficacy Study

by Robert Morgan; Bradley Sanville; Shashank Bathula; Shaban Demirel; R. Serene Perkins; Gordon E. Johnson –
Focused Cardiac Ultrasound (FoCUS) is a relatively new technology that requires training and mentoring. The use of a FoCUS simulator is a novel training method that may prompt greater adoption of this technology by physicians at different levels of training and experience. The objective of this study was to determine if simulation training using an advanced echo simulator (Real Ultrasound®) is a feasible means of delivering training in FoCUS.