Development and Remodeling of Point-of-Care Ultrasound Education for Emergency Medicine Residents in Resource Limited Countries during the COVID-19 Pandemic

Ienghong, Kamonwon; Cheung, Lap Woon; Tiamkao, Somsak; Bhudhisawasdi, Vajarabhongsa; Apiratwarakul, Korakot

doi:10.3390/tomography7040060

Cited by 6 publications

(7 citation statements)

References 41 publications

(45 reference statements)

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“…(1) our residents had limited experience performing OB-GYN POCUS as they only used transabdominal ultrasonography in patients with abdominal pain and/or vaginal bleeding and a positive pregnancy test to screen for the presence of an intrauterine pregnancy (IUP) in the emergency department. It can also be noted that images collected from both transabdominal ultrasonography and transvaginal ultrasonography have ultrasound artifacts [19], which all emergency physicians who use the modality should have sufficient education and practice to be aware of these, and (2) from our previous study [14], it was noted that the frequency of this operation was less in number of times it was performed than other operations. Other results from this study showed that the competency of image acquisition for cardiac images demonstrated varied in score from 1-5.…”

Section: Discussionmentioning

confidence: 97%

“…A previous study based in Thailand [14] demonstrated emergency medicine residents should provide POCUS knowledge in terms of POCUS used in emergency patients. To achieve competence in POCUS, emergency medicine residents must know how to use ultrasonography to detect both normal and abnormal anatomy and physiology, especially in situations most similar to actual patients' clinical context.…”

Section: Introductionmentioning

confidence: 99%

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Integrating Point of Care Ultrasound Education into Clinical Practice at the Emergency Department

et al. 2022

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Point of care ultrasound (POCUS) competency is now required learning for emergency medicine trainees. However, there is a wide range of areas that need to be assessed when determining competence. Therefore, this study aims to evaluate competence levels of POCUS skill acquisition including the areas of image acquisition, image interpretation and clinical integration of the emergency medicine residents while on shift in real clinical practice situations. This was a retrospective descriptive study. This study was conducted at Srinagarind Hospital, Thailand from January 2021 through December 2021. The data were collected and reviewed from electronic medical records, ultrasound images and video clips. All POCUS competency skills were assessed by researcher staff. Our results demonstrated that our learners had overall satisfactory competence of image acquisition, satisfactory image interpretation skills, and good clinical integration skills. However, obstetrics and gynecology (OB-GYN) ultrasound scores were poor and cardiac ultrasound had the most varied score of image quality. This study clearly showed the measurable benefits of a POCUS course being integrated into real clinical practice.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Integrating Point of Care Ultrasound Education into Clinical Practice at the Emergency Department

et al. 2022

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“…27 Training courses in POCUS were limited in the medical training center, especially for emergency medicine residents. 28 This initial effort to apply POCUS in prehospital care needs to be reproduced in the community to improve the current situation. The trained emergency medicine physicians could be potential trainers in future training programs for the other levels of EMS providers.…”

Section: Discussionmentioning

confidence: 99%

The Utilization of Handheld Ultrasound Devices in a Prehospital Setting

Ienghong

Cheung

Tiamkao

et al. 2022

Prehosp. Disaster med.

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Introduction: Prehospital ultrasounds can be considered a new form of diagnostic tool when taking into account their small structure and due to the fact that nowadays, they are used in the care of emergency patients. However, at present, there is no study regarding the advantage of ultrasound usage in prehospital settings in Thailand. Study Objective: This study aims to determine the sonographic characteristics recorded by handheld ultrasounds used in prehospital care and the diagnostic accuracy of ultrasounds for prehospital patients. Methods: A cross-sectional study was conducted on prehospital patients who underwent point-of-care ultrasound (POCUS) examination on Emergency Medical Service (EMS) operations at Srinagarind Hospital, Thailand from January 2021 through December 2021. The ultrasound images, the electronic emergency department medical records, and the EMS database were recorded and reviewed by a team of emergency physicians. The quality of prehospital ultrasound examinations was assessed by comparing the diagnoses at the scene with those taken at the hospital. Results: One hundred sixty-nine prehospital patients who received POCUS examinations were examined over a one-year period. All (100.0%) of the scans were for medical cases. No ultrasound protocol was used in the prehospital care. Two hundred eight POCUS examinations were performed in this study. The most common POCUS indication was dyspnea (45.6%), followed by hypotension/shock (30.1%), and finally syncope (8.2%). The most common area where POCUS was performed was on the lung (37.0%), followed by the inferior vena cava (30.8%), and finally for cardiac cases (26.4%). This study found that 34.9% of sonographic findings could be considered abnormal. The diagnoses of prehospital patients were confirmed by using POCUS in 66 cases (39.1%) with the accuracy of prehospital diagnosis reaching a peak of 75.8%. Conclusion: This study shows POCUS examinations can be effectively used in prehospital care. The prehospital diagnosis given by physicians administering treatment who used POCUS examinations correlated with the in-hospital diagnosis.

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“…The value of P was determined based on data extracted from a previously published study. 13 To ensure statistical significance, a minimum sample size of eight was deemed appropriate for this particular investigation.…”

Section: Methodsmentioning

confidence: 99%

An in-Depth Examination of the Characteristics of Pre-Hospital Point-of-Care Ultrasound Training Among Emergency Medicine Residents in Laos as Part of an Overseas Elective Rotation

Ienghong,

Gaysonsiri,

Cheung

et al. 2023

AMEP

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Introduction Point of Care Ultrasound (POCUS) training has been offering invaluable guidance in the diagnostic process and treatment strategies, particularly in resource-limited settings. The purpose of this study was to determine participant satisfaction with the structure and scope of POCUS training in overseas elective rotation. Material and Methods A retrospective observational analytical study was undertaken. The study focused on EM residents from Laos who participated in the international elective rotation at the Khon Kaen University during the academic years 2020–2021 and 2022–2023. The research involved an exploration of training data related to this course, encompassing participant characteristics, the structure and scope of POCUS training, the training assessments, and post completion surveys of participants. Results The study involved 24 participants. The course was characterized by its status as an international elective program prehospital POCUS training for post graduate year 3 students. The duration of the rotation ranged from 2 to 4 weeks. Interestingly, in the academic year 2022–2023, the duration of POCUS training was notably extended to 8 hours, accounting for 4.76% of the total time. The training encompassed peer-to-peer didactic lectures, bedside teaching, and observational case studies at the Emergency Department (ED). The results of our survey, boasting a 100% response rate, indicated participants’ contentment with the academic performance, the abundance of learning resources, and the knowledge gained from this rotation that would aid their future careers. The overall satisfaction with this course was highly rated, falling into the “satisfy” and “highly satisfy” categories. However, certain challenges were reported, including feelings of isolation due to the distance from relatives, concerns related to interpersonal relationships with colleagues, and a sense of being isolated. Conclusion The participants were highly satisfied to the structure and scope of this course. The overseas elective rotation significantly enhanced the knowledge of Laos EM residents’ in POCUS and underscored the crucial importance of this course in EM training.

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Development and Remodeling of Point-of-Care Ultrasound Education for Emergency Medicine Residents in Resource Limited Countries during the COVID-19 Pandemic

Cited by 6 publications

References 41 publications

Integrating Point of Care Ultrasound Education into Clinical Practice at the Emergency Department

Integrating Point of Care Ultrasound Education into Clinical Practice at the Emergency Department

The Utilization of Handheld Ultrasound Devices in a Prehospital Setting

An in-Depth Examination of the Characteristics of Pre-Hospital Point-of-Care Ultrasound Training Among Emergency Medicine Residents in Laos as Part of an Overseas Elective Rotation

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