Objectives: Emergency physicians (EPs) frequently evaluate patients at risk for diseases that cause optic disc swelling, and they may encounter conditions that make traditional fundoscopy difficult or impossible. The objective was to assess whether EP-performed point-of-care (POC) ultrasound (US) could accurately assess swelling of the optic disc.Methods: This was a blinded, prospective study using a convenience sample of patients presenting to a neuroophthalmology clinic who were thought to be at risk for conditions associated with optic disc edema. Two EPs performed POC US examinations. Patients then underwent standard clinical assessment by a specialist.Results: Fourteen patients were assessed with disc swelling noted on dilated fundoscopic exam in 11 of 28 (39%) eyes. A maximum disc height greater than 0.6 mm as measured by US predicted the presence of optic disc edema noted on fundoscopic exam, with a sensitivity of 82% (95% confidence interval [CI] = 48% to 98%) and a specificity of 76% (95% CI = 50% to 93%). A threshold value of 1.0 mm for disc height yielded a sensitivity of 73% (95% CI = 39% to 94%) and a specificity of 100% (95% CI = 81% to 100%). Measurements of disc height as determined by optical coherence tomography (OCT) exhibited good correlation when compared to US measurements (r = 0.836, p < 0.0001, 95% CI = 0.65 to 0.93).Conclusions: These data suggest that EP-performed POC US can detect clinically apparent optic disc swelling. Because sonography can be performed readily at the bedside, even in cases where fundoscopy is difficult or impossible, this technique may prove to be a valuable tool for the assessment of optic disc swelling in the emergency department (ED).ACADEMIC EMERGENCY MEDICINE 2013; 20:920-925

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Rationale and Objectives: We aimed to assess the impact of our institution's recently created point-of-care ultrasound (POCUS) course for preclinical medical students by examining its effect on first-year-level medical knowledge, self-reported skill level, and beliefs regarding the importance of ultrasound in future clinical practice. Materials and Methods:A total of 18 first-year medical students completed a 5-month near-peer-led training program in POCUS consisting of 3-hour teaching sessions (7), 4-hour clinical sessions (10-12), and an independent study. Students completed pre-and postprogram assessments examining (1) student perceptions about ultrasound and its importance to future careers, (2) students' self-reported skill level with ultrasound, and (3) performance on an anatomy and physiology knowledge quiz. Scores and responses were compared to 20 controls. Results:The majority of students believed that ultrasound was useful for learning anatomy and would be important in their future clinical practice. Students who completed our training program tended to perform better than controls on a test of medical knowledge. Despite reporting far fewer hours of formal ultrasound training, control students rated their skill level comparably to POCUS-trained students.Conclusions: This study provides evidence that ultrasound is well received by medical students and may be useful for teaching basic anatomy concepts.

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