“With the changing landscape of global health, there is a growing need for high-quality emergency care in the developing world. Time-sensitive illnesses such as infectious diseases, traumatic injuries, dehydration, cardiac disease and peripartum complications contribute great to the burden of disease in low- and middle-income countries […] Point-of-care (POC) ultrasound by trained providers is an attractive solution to the scarcity of imaging services in low-income settings. POC ultrasound takes the ultrasound out of the hands of the radiologist or technician and places it in the hands of the treating clinician.”
Objective: To describe the outcomes and curriculum components of an educational program to train non-physician clinicians working in a rural, Ugandan emergency department in the use of point-of-care (POC) ultrasound.
Methods: The use of point-of-care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands-on practical sessions. Lectures were tailored to care providers’ knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorized as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded.
Results: A total of 22 639 patients were evaluated in the emergency department by emergency care providers, and 2185 point-of-care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point-of-care ultrasound studies were performed more frequently than radiology department-performed studies. Positive findings were documented in 46% of all examinations.
Conclusions: We describe a novel curriculum for point-of-care ultrasound education of non-physician emergency practitioners in a resource-limited setting. These non-physician clinicians integrated ultrasound into clinical practice and utilized this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings.